Active NPI
Elena Piceno
- Community Health Worker
- Woodburn, OR
National Provider Identifier
1467159665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000108253
- Practice address
- 1175 Mount Hood Ave
Woodburn, OR 97071-9060 - Phone
- (503) 982-0635
- NPI assigned
- Feb 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000108253 | OR | Primary |
Addresses
Primary practice location
1175 Mount Hood Ave
Woodburn, OR 97071-9060
Mailing address
1175 Mount Hood Ave
Woodburn, OR 97071-9060
Phone (503) 982-0635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| THW00018253 | Other | OR | OREGON HEALTH AUTHORITY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| THW000108253 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675814400000",
"number": "1467159665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 MOUNT HOOD AVE",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970719060",
"telephone_number": "503-982-0635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 MOUNT HOOD AVE",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970719060",
"telephone_number": "503-982-0635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICENO",
"first_name": "ELENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-08",
"last_updated": "2023-02-08",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000108253",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON HEALTH AUTHORITY",
"identifier": "THW00018253",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodburn, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.