NPIMap

Organization Active NPI

Kaizen Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaverton, OR
National Provider Identifier
1447925367
Registry record updated Sep 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
KAIZEN PSYCHIATRIC SERVICES LLC
Practice address
14845 SW Murray Scholls Dr Ste 110
Beaverton, OR 97007-9237
Phone
(360) 836-0171
Fax
(618) 882-4174
NPI assigned
Aug 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2021

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

Authorized official

Name
Molly Rodden, FNP, PMHNPNPI 1144620295
Title
Owner
Phone
(360) 836-0171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

14845 SW Murray Scholls Dr Ste 110
Beaverton, OR 97007-9237

Mailing address

14845 SW Murray Scholls Dr.
Ste. 110, PMB 412
Beaverton, OR 97007-0412
Phone (360) 836-0171

Other names 1

  • Kaizen Collective Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211014003034 OR Part B Supplier - Clinic/Group Practice 6406254846 Receives reassigned benefits from 3 practitioners
Practice locations: Vancouver, WA
O20211018000334 WA Part B Supplier - Clinic/Group Practice 6406254846 Receives reassigned benefits from 1 practitioner
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

14845 SW Murray Scholls Dr
Ste 110
Beaverton, OR 97007
Phone (360) 836-0171

516 SE Chkalov Dr
Apt 49
Vancouver, WA 98683
Phone (360) 836-0171

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630713600000",
    "number": "1447925367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14845 SW MURRAY SCHOLLS DR.",
            "address_2": "STE. 110, PMB 412",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970070412",
            "telephone_number": "360-836-0171",
            "fax_number": "618-882-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14845 SW MURRAY SCHOLLS DR STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079237",
            "telephone_number": "360-836-0171",
            "fax_number": "618-882-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A",
        "authorized_official_last_name": "RODDEN",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-836-0171",
        "authorized_official_credential": "FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaizen Collective",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.