Active NPI
Raelynn Leann Freden
- Professional Counselor
- Portland, OR
National Provider Identifier
1336670132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 10373 NE Hancock St Ste 200
Portland, OR 97220-3873 - Phone
- (503) 253-6754
- NPI assigned
- Mar 23, 2017
- Last updated
- Jul 5, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14-12-08 | OR | |
| Mental Health Counselor | 101YM0800X | NU | ||
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
10373 NE Hancock St Ste 200
Portland, OR 97220-3873
Mailing address
PO Box 8459
Portland, OR 97207-8459
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": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1336670132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10373 NE HANCOCK ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972203873",
"telephone_number": "503-253-6754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDEN",
"first_name": "RAELYNN",
"middle_name": "LEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "14-12-08",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Fred Meyer Stores Inc (Fred Meyer Pharmacy)
- Fred Meyer Stores Inc (Fred Meyer Pharmacy)
- Fred Meyer Stores Inc (Fred Meyer Pharmacy)
- Susan Dianne Fredd-Allison, LCSW
- Heidi Lynn Fredeen
- Desiree Fredenburg, LMT
- Frederick T Waller MD PC
- Brent Frederick, RPH
- Carrie E. Frederick, MD
- Eric J Frederick, AU.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.