NPIMap

Organization Active NPI

Pathfinder Clubhouse

  • Community/Behavioral Health Agency
  • Corvallis, OR
National Provider Identifier
1225861446
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHFINDER CLUBHOUSE
Practice address
250 NW 1St St Ste 110
Corvallis, OR 97330-4836
Phone
(458) 217-3041
Fax
(855) 962-2388
NPI assigned
Aug 22, 2024
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Elizabeth Hazlewood, CHWNPI 1164007241
Title
Executive Director
Phone
(458) 217-3041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

250 NW 1St St Ste 110
Corvallis, OR 97330-4836

Mailing address

PO Box 1414
Corvallis, OR 97339-1414
Phone (423) 463-9622

National Provider Directory

National Provider Directory

Locations

250 NW 1st St
#110
Corvallis, OR 97330
Phone (458) 217-3040

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1225861446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391414",
            "telephone_number": "423-463-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NW 1ST ST STE 110",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304836",
            "telephone_number": "458-217-3041",
            "fax_number": "855-962-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHFINDER CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "HAZLEWOOD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "458-217-3041",
        "authorized_official_credential": "CHW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.