Active NPI
Alexandra Weckel
- Peer Specialist
- Beaverton, OR
National Provider Identifier
1205514619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 23-CRM-1659
- Practice address
- 16365 NW Twin Oaks Dr
Beaverton, OR 97006 - Phone
- (503) 828-3402
- NPI assigned
- Jul 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 23-CRM-1659 | OR | Primary |
Addresses
Primary practice location
16365 NW Twin Oaks Dr
Beaverton, OR 97006
Mailing address
16055 SW Walker Rd
#443
Beaverton, OR 97006
Phone (503) 828-3402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-CRM-1659 | OR | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wolf Pack Consulting and Therapeutic Services LLC | Current | Accepting new patients |
Locations
16055 SW Walker Rd
Beaverton, OR 97006
Phone (503) 828-3402
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Beaverton, OR
- NPI 1336677988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1205514619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16055 SW WALKER RD",
"address_2": "#443",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-828-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16365 NW TWIN OAKS DR",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-828-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WECKEL",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-06",
"last_updated": "2023-07-06",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "23-CRM-1659",
"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 Jul 6, 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.