Denisse Baltazar Molinar

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11220 SE Stark St
Portland, OR 97216-3379

Phone

(971) 361-8303

NPI assigned

Nov 23, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1154030658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 SUNNYSIDE RD SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163379",
            "telephone_number": "971-361-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR MOLINAR",
        "first_name": "DENISSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "3350359",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denisse@connectivetherapycollective.com",
            "affiliation": "N",
            "address_1": "11220 SE Stark St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972163379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven Balshem
• Richard Marion Balsiger Jr., D.C.
• Katharine S Balske
• Aubrey Balster, ND
• Danielle Balsz, R.N.
• Kelly Mary Baltazar, N.D., D.C.
• Oleg Balter, MD
• Bill-Bern Balthazard
• Kyle Matthew Baltrusch, MD
• Ellen Scott Baltus, LCSW

• Student in an Organized Health Care Education/Training Program in Portland, OR
• Providers in Portland, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.