Michael Dean Wade, MS, LMT

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

343 W Powell Blvd
Gresham, OR 97030-7050

Phone

(503) 666-9171

Fax

(503) 667-9072

NPI assigned

Feb 5, 2007

Last updated

Apr 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1215076476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W POWELL BLVD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307050",
            "telephone_number": "503-666-9171",
            "fax_number": "503-667-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W POWELL BLVD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307050",
            "telephone_number": "503-666-9171",
            "fax_number": "503-667-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MS, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "7803",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Vossen, SLP
• Pamela Walker Vredevelt, LPC
• Brian Laurie Vroom, D.C.
• W2 Powell Valley, LLC (Powell Valley Assisted Living Community)
• Georgianna Wade, LMT
• Shyra Q Wade, CSWA/QMHA-I
• Brian Wadyka, PHARM.D.
• Michelle K Waggoner, DC
• Shaylene Tamara Waggoner, BSN, RN
• Andrew Wagner

• Pastoral Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Pastoral Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.