Active NPI
Kristin Rebecca Riley, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1467583476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 003460
- Practice address
- 2727 SE Alder St
Portland, OR 97214-3015 - Phone
- (503) 234-0175
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 003460 | OR | Primary |
Addresses
Primary practice location
2727 SE Alder St
Portland, OR 97214-3015
Mailing address
4906 SE 50TH Ave
Portland, OR 97206-4911
Phone (503) 333-7844
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 |
|---|---|---|---|
| 003460 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488326400000",
"number": "1467583476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4906 SE 50TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972064911",
"telephone_number": "503-333-7844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 SE ALDER ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143015",
"telephone_number": "503-234-0175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KRISTIN",
"middle_name": "REBECCA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2017-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "003460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.