Individual provider Active NPI

Kendyl Bree Garrow, MSW

  • Clinical Social Worker
  • Beaverton, OR
National Provider Identifier
1194380998
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10806 Issued in OR
Practice address
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone
(971) 262-9150
Fax
(971) 262-9151
NPI assigned
May 7, 2019
Reactivated
Jun 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 L10806 OR Primary
Social Worker 104100000X

Addresses

Primary practice location

15700 SW Greystone CT
Beaverton, OR 97006-6011

Mailing address

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (971) 262-9150

Other practice location 1

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone (503) 220-8262

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318001836 OR Practitioner - Clinical Social Worker 3476948944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10806ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University CurrentSince Mar 13, 2023 Accepting new patients
University Professional Services CurrentSince Mar 1, 2022 Accepting new patients
Oregon Health & Science University Current Accepting new patients
University Professional Services CurrentSince Mar 1, 2022 Accepting new patients
University Professional Services Current Accepting new patients
Oregon Health & Science University CurrentSince Mar 13, 2023 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1194380998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15700 SW GREYSTONE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970066011",
            "telephone_number": "971-262-9150",
            "fax_number": "971-262-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 SW GREYSTONE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970066011",
            "telephone_number": "971-262-9150",
            "fax_number": "971-262-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 SW US Veterans Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392964",
            "country_code": "US",
            "telephone_number": "503-220-8262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARROW",
        "first_name": "KENDYL",
        "middle_name": "BREE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "deactivation_date": "2019-05-07",
        "reactivation_date": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10806",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.