NPIMap

Organization Active NPI

West Linn Clementine, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • West Linn, OR
National Provider Identifier
1184423584
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
WEST LINN CLEMENTINE, INC
Practice address
22035 S Wisteria Rd
West Linn, OR 97068-9231
Phone
(971) 314-6530
Fax
(971) 228-1680
NPI assigned
Mar 10, 2025
Last updated
Apr 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Lauren Lau
Title
Contracting Director
Phone
(724) 989-4564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

22035 S Wisteria Rd
West Linn, OR 97068-9231

Mailing address

6100 SW 76TH St
South Miami, FL 33143-5002

National Provider Directory

National Provider Directory
Tax ID family
Clementine Portland2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1184423584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435002",
            "fax_number": "305-740-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22035 S WISTERIA RD",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970689231",
            "telephone_number": "971-314-6530",
            "fax_number": "971-228-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LINN CLEMENTINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CONTRACTING DIRECTOR",
        "authorized_official_telephone_number": "724-989-4564"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.