Cary M Shore, DNP-PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201903897NP-PP Issued in OR

Practice address

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

Phone

(503) 664-9451

Fax

(503) 386-3230

NPI assigned

Aug 6, 2017

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health, WA

  Medicare reassignment NPD
• Mindrx, LLC

  • Psychiatry Physician
  • Portland, OR
  • NPI 1235869488
  NPD

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1346765880",
    "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": {
        "last_name": "SHORE",
        "first_name": "CARY",
        "middle_name": "M",
        "credential": "DNP-PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-06",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "2017010049",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201903897NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brettina Shoop
• Sheryl Ann Shope
• Daniel Ryan Shor
• Katia Lease Shorb, FNP
• Amy M Shore, BS
• Dmitriy Shore, PA-C
• Howard Everett Shore, PH.D, LPC
• Peter Shore, PSY.D.
• Rachel Shore, MD STUDENT
• Shore Shannon Shore

• All providers in Portland, OR
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.