NPIMap

Individual provider Active NPI

Samuel Waine Oswald

  • Counselor
  • Portland, OR
National Provider Identifier
1386070795
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
0177 Issued in OR
Practice address
707 NE Couch St
Portland, OR 97232-2922
Phone
(503) 542-4603
Fax
(503) 233-6093
NPI assigned
Sep 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0177 OR Primary

Addresses

Primary practice location

707 NE Couch St
Portland, OR 97232-2922

Mailing address

6455 SW Nyberg LN Apt H101
Tualatin, OR 97062-7450
Phone (503) 805-5716

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

State licenses

LicenseStateTypeSpecialty
0177ORMDVoluntary or Charitable Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Janus Youth Programs, Inc. Past Accepting new patients
Janus Youth Programs Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1386070795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 SW NYBERG LN APT H101",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627450",
            "telephone_number": "503-805-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322922",
            "telephone_number": "503-542-4603",
            "fax_number": "503-233-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALD",
        "first_name": "SAMUEL",
        "middle_name": "WAINE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "0177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.