Active NPI
James McDonald
- Mental Illness Community Based Residential Treatment Facility
- Beaverton, OR
National Provider Identifier
1295196434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Practice address
- 4585 SW 185TH Ave
Beaverton, OR 97078-1557 - Phone
- (503) 484-4427
- NPI assigned
- Mar 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
4585 SW 185TH Ave
Beaverton, OR 97078-1557
Mailing address
4585 SW 185TH Ave
Beaverton, OR 97078-1557
Phone (503) 484-4427
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1295196434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4585 SW 185TH AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970781557",
"telephone_number": "503-484-4427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4585 SW 185TH AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970781557",
"telephone_number": "503-484-4427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.