Bettina Boles

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A15454 Issued in OR

Practice address

3415 SE Powell Blvd
Portland, OR 97202-3371

Phone

(503) 234-9591

NPI assigned

Sep 23, 2014

Last updated

Sep 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Janus Youth Programs

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1912331646
  NPD (past)
• Janus Youth Programs, Inc.

  • Voluntary or Charitable Agency
  • Portland, OR
  • NPI 1003248642
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1295137180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "612-834-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "503-234-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "BETTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A15454",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OR",
            "license": "549944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Boldt
• Laura Bolen
• Scott C Bolen, Q.M.H.A.
• Willow Mae Bolen, WILLOW BOLEN
• Lindsay Ann Bolerjack
• Matthew S.a. Boles, MD
• Jacquelyn Boliba Soule
• Amanda Bolich
• Erin S Bolken, PAC
• Joshua William Bolle

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.