Active NPI
Juliet Sillicy Munoz, CHW
- Community Health Worker
- Portland, OR
National Provider Identifier
1285200238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000104637
- Practice address
- 2020 SE 182ND Ave
Portland, OR 97233-5692 - Phone
- (503) 988-5558
- Fax
- (503) 988-5660
- NPI assigned
- Jun 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000104637 | OR | Primary |
Addresses
Primary practice location
2020 SE 182ND Ave
Portland, OR 97233-5692
Mailing address
2020 SE 182ND Ave
Portland, OR 97233-5692
Phone (503) 988-5558
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| THW000104637 | Other | OR | OREGON HEALTH AUTHORITY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000104637 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624406400000",
"number": "1285200238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 SE 182ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335692",
"telephone_number": "503-988-5558",
"fax_number": "503-988-5660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 SE 182ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335692",
"telephone_number": "503-988-5558",
"fax_number": "503-988-5660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ",
"first_name": "JULIET",
"middle_name": "SILLICY",
"credential": "CHW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-01",
"last_updated": "2021-06-23",
"certification_date": "2021-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000104637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON HEALTH AUTHORITY",
"identifier": "THW000104637",
"state": "OR"
}
],
"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 Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.