Individual provider Active NPI

Eddie Chai Yuen Lui

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1386186716
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11040 Issued in OR
Practice address
8235 SW Glencreek CT
Portland, OR 97223-9330
Phone
(503) 929-2431
NPI assigned
Nov 16, 2016
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L11040 OR Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

8235 SW Glencreek CT
Portland, OR 97223-9330

Mailing address

8235 SW Glencreek CT
Portland, OR 97223-9330
Phone (503) 929-2431

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712003895 OR Practitioner - Clinical Social Worker 3173983855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1815 SW Marlow Ave
Suite 218
Portland, OR 97225-5187
Phone (503) 444-4862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L11040ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC CurrentSince May 31, 2023 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince May 31, 2023 Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

1815 SW Marlow Ave
Ste 218
Portland, OR 97225
Phone (503) 444-4862

9755 SW Barnes Rd
Ste 650
Portland, OR 97225
Phone (503) 444-4862

7455 SW Beveland Rd
Tigard, OR 97223
Phone (503) 624-2600

18765 SW Boones Ferry Rd
Ste 100
Tualatin, OR 97062
Phone (503) 612-1000

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.eddielui@148835.advancedmd-direct.com

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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1386186716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 SW GLENCREEK CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972239330",
            "telephone_number": "503-929-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8235 SW GLENCREEK CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972239330",
            "telephone_number": "503-929-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUI",
        "first_name": "EDDIE CHAI YUEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11040",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.