FDS Alliance Residential LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

FDS ALLIANCE RESIDENTIAL LLC

Practice address

380 NE 178TH Ave
Portland, OR 97230-6658

Phone

(971) 431-6436

NPI assigned

Feb 3, 2026

Organization subpart

No

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

Authorized official

Name

Gemechis Abdissa, RN

Title

Managing Member

Phone

(971) 431-6436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1407707805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 NE 178TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306658",
            "telephone_number": "971-431-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 NE 178TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306658",
            "telephone_number": "971-431-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FDS ALLIANCE RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "ABDISSA",
        "authorized_official_first_name": "GEMECHIS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "971-431-6436",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Fay, PA-C
• Katharine Elizabeth Fazal, LMFT
• Hannah Fazendin, LMT
• Sergio Fazio, MD, PHD
• Erica Bernadette Fazzini, PA-C
• Samantha Larae Feagins
• Forrest Wayne Fearington, MD
• James Douglas Fearl, JAMES FEARL
• Fearless With Food, LLC
• Bruce Wayne Feathers

• Mental Illness Community Based Residential Treatment Facility in Portland, OR
• Providers in Portland, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.