Tisa Pickering, MSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

NO.21-QMHA-R-1548 Issued in OR

Practice address

308 SW 1St Ave
Portland, OR 97204-3400

Phone

(503) 808-1256

NPI assigned

Sep 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1184392201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 SW HALL ST APT 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972016117",
            "telephone_number": "503-381-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 SW 1ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043400",
            "telephone_number": "503-808-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERING",
        "first_name": "TISA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "NO.21-QMHA-R-1548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristan Elizabeth Pickell
• Angela Leah Pickens, MD
• Stacy Pickerel
• Brianna M Pickering, MD
• Ronnie Lee Pickering, PHARM.D.
• Mary Ellis Pickett, MD
• Barbara Ann Pickle, LMT
• Tyler Pickle, LCSW, CADC-I
• Aaron Anthony Pickrell, M.D.
• Shaylie Lucille Pickrell

• Case Manager/Care Coordinator in Portland, OR
• Providers in Portland, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.