Individual provider Active NPI

Daniela Letz, PMHNP, LCSW

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1184785727
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201150083NP Issued in OR
Practice address
9205 SW Barnes Rd
Portland, OR 97225
Phone
(503) 327-1598
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3781 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201150083NP OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225

Mailing address

1795 NW 143Rd Ave
Unit 3
Portland, OR 97229-4373
Phone (503) 327-1598

Other practice location 1

1795 NW 143rd Ave
Unit 3
Portland, OR 97229-4373
Phone (503) 327-1598

Other practice location 2

847 NE 19th Ave Ste 100
Portland, OR 97232-2684
Phone (503) 238-0769

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dletz111397@oc.providencedirect.org
Direct Messaging Address dletz111397@oc.providencedirect.org

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130507000192 OR Practitioner - Nurse Practitioner 1355588526 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

4212 SE Division St
Suite 100
Portland, OR 97206-1680
Phone (503) 236-7166

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L3781ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health Current Accepting new patients
Cascadia Health CurrentSince Apr 23, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 4, 2015 Accepting new patients
Interventional and Vascular Consultants PC CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 4, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2017 Accepting new patients

Locations

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

847 NE 19th Ave
Ste 100
Portland, OR 97232
Phone (503) 552-6203

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4212 SE Division St
Ste 100
Portland, OR 97206
Phone (503) 238-0705

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

2701 NW Vaughn St
Ste 325
Portland, OR 97210
Phone (503) 610-6563

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1184785727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 NW 143RD AVE",
            "address_2": "UNIT 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972294373",
            "telephone_number": "503-327-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-327-1598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1795 NW 143rd Ave",
            "address_2": "Unit 3",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972294373",
            "country_code": "US",
            "telephone_number": "503-327-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "847 NE 19th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322684",
            "country_code": "US",
            "telephone_number": "503-238-0769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LETZ",
        "first_name": "DANIELA",
        "credential": "PMHNP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3781",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201150083NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dletz111397@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dletz111397@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5251 NE Glisan St Bldg A2nd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972133052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.