Collective Roots Apg

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

COLLECTIVE ROOTS APG

Practice address

5830 NE Alameda St
Portland, OR 97213-3426

Phone

(360) 910-2870

NPI assigned

Apr 15, 2024

Last updated

Apr 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robin Bergeron, CRM

Title

Executive Director

Phone

(360) 910-2870

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1205680493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 NE ALAMEDA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133426",
            "telephone_number": "360-910-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 NE ALAMEDA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133426",
            "telephone_number": "360-910-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE ROOTS APG",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-910-2870",
        "authorized_official_credential": "CRM"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Collaer
• Roberto Carlos Barcelona Collantes, M.D.
• Julia Collazo
• Collective Care Clinic, LLC
• Collective Insight Therapy Services, LLC
• Colleen Donnelly Acupuncture, LLC
• Colleen Gibson Acupuncture LLC (Cultivate Wellness Acupuncture & Massage)
• Colleen Sara LLC
• Candace Lynne Colleknon, MSCN
• Benjamin Colley

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.