Individual provider Active NPI

Leah Bloomberg, DNP, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Oswego, OR
National Provider Identifier
1346782117
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201807305NP-PP Issued in OR
Practice address
5 Centerpointe Dr Ste 400
Lake Oswego, OR 97035-8661
Phone
(503) 994-1502
NPI assigned
Nov 10, 2016
Last updated
Mar 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201807305NP-PP OR Primary
Mental Health Counselor 101YM0800X NU
Registered Nurse 163W00000X 201607796RN OR

Addresses

Primary practice location

5 Centerpointe Dr Ste 400
Lake Oswego, OR 97035-8661

Mailing address

5 Centerpointe Dr Ste 400
Lake Oswego, OR 97035-8661
Phone (503) 994-1502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181030001488 OR Practitioner - Nurse Practitioner 4880947324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201607796RNORMDRegistered Nurse
201807305NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Aug 27, 2018 Accepting new patients
Cascadia Health Current Accepting new patients

Locations

10373 NE Hancock St
Ste 200
Portland, OR 97220
Phone (503) 253-6754

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

847 NE 19th Ave
Portland, OR 97232
Phone (503) 222-0707

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1346782117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358661",
            "telephone_number": "503-994-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358661",
            "telephone_number": "503-994-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMBERG",
        "first_name": "LEAH",
        "credential": "DNP, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201807305NP-PP",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201607796RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.