Organization Active NPI

Tranquil Roots LLC

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1205742145
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRANQUIL ROOTS LLC
Practice address
1111 E Burnside St Ste 100
Portland, OR 97214-1850
Phone
(971) 438-3088
NPI assigned
Aug 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Ethan Randall, MSW, LCSW
Title
Owner
Phone
(971) 438-3088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1111 E Burnside St Ste 100
Portland, OR 97214-1850

Mailing address

2705 E Burnside St Ste 206
PMB #44
Portland, OR 97214-1768
Phone (971) 438-3088

Other practice location 1

2705 E Burnside St Ste 206
Portland, OR 97214-1768
Phone (971) 438-3088

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1787184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1205742145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E BURNSIDE ST STE 206",
            "address_2": "PMB #44",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141768",
            "telephone_number": "971-438-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E BURNSIDE ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141850",
            "telephone_number": "971-438-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 E Burnside St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141768",
            "country_code": "US",
            "telephone_number": "971-438-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRANQUIL ROOTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-438-3088",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.