Mason Clark Boucher

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2236 SE Belmont St
Portland, OR 97214-2817

Phone

(503) 445-7699

NPI assigned

Sep 12, 2016

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

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cascade AIDS Project

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1275076168
  Medicare reassignment NPD
• Cascade AIDS Project

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1336902394
  NPD

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1154879781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142817",
            "telephone_number": "503-445-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "MASON",
        "middle_name": "CLARK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Ann Botwinick
• Ora Naomi Botwinick, MD
• Jack Bouba
• Sonia Bouchard
• Aurora Curelaru Boucher, FNP
• Melissa Kay Boucher, DO
• Ashley Nicole Boudet, N.D.
• Eilis Ann Boudreau, MD
• Elizabeth Jean Boudreau, PA-C
• Tina Han Bouillion, MS, CADC II, LPC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.