Tia Amundson, B.S.

Key facts

NPI

1457782344

Entity type

Individual (NPI type 1)

Primary specialty

Counselor 101Y00000X

Practice address

816 SE 15TH St
Pendleton, OR 97801-3254

Phone

(541) 276-5433

NPI assigned

Dec 3, 2013

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Homestead Youth & Family Services, Inc. Children's Substance Abuse Rehabilitation Facility · Pendleton, OR · NPI 1629270780
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Bachelor of Science

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 3, 2013.

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1457782344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010260",
            "telephone_number": "541-276-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 SE 15TH ST",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013254",
            "telephone_number": "541-276-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "TIA",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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