Individual provider Active NPI

Margaret Diane Fraze, CADC I/QMHA-R

  • Addiction (Substance Use Disorder) Counselor
  • Tigard, OR
National Provider Identifier
1174087613
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
22-10-10550 Issued in OR
Practice address
10763 SW Greenburg Rd Ste 100
Tigard, OR 97223-5492
Phone
(503) 686-8159
Fax
(503) 621-0200
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 21-QMHA-R-1493 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 22-10-10550 OR Primary

Addresses

Primary practice location

10763 SW Greenburg Rd Ste 100
Tigard, OR 97223-5492

Mailing address

1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044

Other identifiers 1

IdentifierTypeStateIssuer
500809449MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21-QMHA-R-1493ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1174087613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10763 SW GREENBURG RD STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235492",
            "telephone_number": "503-686-8159",
            "fax_number": "503-621-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZE",
        "first_name": "MARGARET",
        "middle_name": "DIANE",
        "credential": "CADC I/QMHA-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "21-QMHA-R-1493",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "22-10-10550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500809449",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.