NPIMap

Organization Active NPI

Forwardstride

  • Prevention Professional
  • Beaverton, OR
National Provider Identifier
1194260927
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
License
579722 Issued in OR
Legal business name
FORWARDSTRIDE
Practice address
18218 SW Horse Tale Dr
Beaverton, OR 97007-9789
Phone
(503) 590-2959
Fax
(503) 590-2969
NPI assigned
Jan 3, 2017
Last updated
Jan 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Authorized official

Name
Amber Varner
Title
Associate Executive Director
Phone
(503) 590-2959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional 405300000X 579722 OR Primary

Addresses

Primary practice location

18218 SW Horse Tale Dr
Beaverton, OR 97007-9789

Mailing address

18218 SW Horse Tale Dr
Beaverton, OR 97007-9789
Phone (503) 590-2959

National Provider Directory

National Provider Directory
Tax ID family
Forward Stride2 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 5

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": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1194260927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18218 SW HORSE TALE DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079789",
            "telephone_number": "503-590-2959",
            "fax_number": "503-590-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18218 SW HORSE TALE DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079789",
            "telephone_number": "503-590-2959",
            "fax_number": "503-590-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARDSTRIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "VARNER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "ASSOCIATE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-590-2959"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OR",
            "license": "579722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.