Individual provider Active NPI

Bryanna Oliver-Palmquist, LMFT

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1164878849
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
T1452 Issued in OR
Practice address
2645 Portland Rd NE
120
Salem, OR 97301-0198
Phone
(503) 390-5637
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X T1452 OR Primary

Addresses

Primary practice location

2645 Portland Rd NE
120
Salem, OR 97301-0198

Mailing address

109 E North St
Newberg, OR 97132-2314

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240206000494 OR Practitioner - Marriage and Family Therapist 4183067259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T1452ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon CurrentSince Jan 1, 2024 Accepting new patients

Locations

360 E 10th Ave
Ste 450
Eugene, OR 97401

11010 SE Division St
Ste 202
Portland, OR 97266
Phone (503) 335-5975

2645 Portland Rd NE
Ste 120
Salem, OR 97301

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1164878849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E NORTH ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971322314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 PORTLAND RD NE",
            "address_2": "120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010198",
            "telephone_number": "503-390-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER-PALMQUIST",
        "first_name": "BRYANNA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "T1452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.