NPIMap

Organization Active NPI

Polk County Mental Health

  • Case Management Agency
  • Dallas, OR
National Provider Identifier
1154447068
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
251B00000X Issued in OR
Legal business name
POLK COUNTY MENTAL HEALTH
Practice address
182 SW Academy St
Suite # 304
Dallas, OR 97338-1922
Phone
(503) 623-9289
Fax
(503) 623-1874
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Donna Jean Kraemer, BA
Title
Service Coordinator
Phone
(503) 623-9289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 251B00000X OR Primary

Addresses

Primary practice location

182 SW Academy St
Suite # 304
Dallas, OR 97338-1922

Mailing address

182 SW Academy St
Suite # 304
Dallas, OR 97338-1922
Phone (503) 623-9289

National Provider Directory

National Provider Directory
Tax ID family
Polk County Health Depart11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154447068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "address_2": "SUITE # 304",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381922",
            "telephone_number": "503-623-9289",
            "fax_number": "503-623-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "address_2": "SUITE # 304",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381922",
            "telephone_number": "503-623-9289",
            "fax_number": "503-623-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRAEMER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "SERVICE COORDINATOR",
        "authorized_official_telephone_number": "503-623-9289",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OR",
            "license": "251B00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.