Active NPI
Prisma Wellness LLC
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1154942142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- PRISMA WELLNESS LLC
- Practice address
- 3705 SE Cesar Chavez Blvd
Portland, OR 97202-1704 - Phone
- (206) 785-1015
- Fax
- (206) 785-1023
- NPI assigned
- Apr 30, 2020
- Last updated
- Oct 10, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Scott Wiener, MD
- Title
- Chief Medical Officer
- Phone
- (206) 785-1015
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
3705 SE Cesar Chavez Blvd
Portland, OR 97202-1704
Mailing address
321 Burnett Ave S FL 2
Renton, WA 98057-2558
Phone (206) 785-1015
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Greenfield, WI
- NPI 1922333996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728518400000",
"number": "1154942142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 BURNETT AVE S FL 2",
"city": "RENTON",
"state": "WA",
"postal_code": "980572558",
"telephone_number": "206-785-1015",
"fax_number": "206-785-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 SE CESAR CHAVEZ BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972021704",
"telephone_number": "206-785-1015",
"fax_number": "206-785-1023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRISMA WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-30",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A",
"authorized_official_last_name": "WIENER",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "206-785-1015",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.