NPIMap

Organization Active NPI

Mindrx, LLC

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1235869488
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MINDRX, LLC
Practice address
555 SE MLK Jr Blvd Unit 105
Portland, OR 97214-2595
Phone
(503) 664-9451
Fax
(503) 386-3230
NPI assigned
Jun 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Anthony Grippo
Title
Office Manager
Phone
(503) 664-9451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

555 SE MLK Jr Blvd Unit 105
Portland, OR 97214-2595

Mailing address

3055 NW Yeon Ave Suite 606
Portland, OR 97210
Phone (503) 664-9451

Other practice location 1

701 NE 136th Ave Ste 200
Vancouver, WA 98684-6937
Phone (503) 664-9451

Other names 1

  • MindRx Group Doing business as

National Provider Directory

National Provider Directory

Locations

2219 Rimland Dr
Ste 346
Bellingham, WA 98226
Phone (503) 664-9451

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1235869488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 NW YEON AVE SUITE 606",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-664-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SE MLK JR BLVD UNIT 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142595",
            "telephone_number": "503-664-9451",
            "fax_number": "503-386-3230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 NE 136th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986846937",
            "country_code": "US",
            "telephone_number": "503-664-9451",
            "fax_number": "503-386-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDRX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-11",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "GRIPPO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-664-9451"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MindRx Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 3, 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.