Individual provider Active NPI

Timothy Paul Joachim

  • Mental Health Counselor
  • Sandy, OR
National Provider Identifier
1457248254
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R11264 Issued in OR
Practice address
39065 Pioneer Blvd Ste 104
Sandy, OR 97055-8088
Phone
(503) 770-0083
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R11264 OR Primary

Addresses

Primary practice location

39065 Pioneer Blvd Ste 104
Sandy, OR 97055-8088

Mailing address

16430 SE Marna Rd
Damascus, OR 97089-8846
Phone (503) 770-0083

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
R11264ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1457248254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16430 SE MARNA RD",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970898846",
            "telephone_number": "503-770-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39065 PIONEER BLVD STE 104",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970558088",
            "telephone_number": "503-770-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOACHIM",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R11264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.