Individual provider Active NPI

Tyanna Benson, LCSW

  • Clinical Social Worker
  • Beaverton, OR
National Provider Identifier
1467762302
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61638009 Issued in WA
Practice address
16100 NW Cornell Rd # 220
Beaverton, OR 97006-7334
Phone
(503) 878-8885
Fax
(971) 297-1360
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW61638009 WA Primary

Addresses

Primary practice location

16100 NW Cornell Rd # 220
Beaverton, OR 97006-7334

Mailing address

65 SW Yamhill St Ste 300
Portland, OR 97204-3316
Phone (503) 523-0296

Other practice location 1

65 SW Yamhill St Ste 300
Portland, OR 97204-3316
Phone (503) 878-8885

Other practice location 2

1200 Executive Pkwy Ste 260
Eugene, OR 97401-2199
Phone (800) 828-8417

Other practice location 3

914 Main St
Vancouver, WA 98660-3136
Phone (503) 878-8885

Other practice location 4

400 NE Mother Joseph Pl
Vancouver, WA 98664-3200
Phone (360) 256-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250505001837 WA Practitioner - Clinical Social Worker 3678090578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Shelton, WA 98584
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW61638009WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Apr 6, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince Sep 1, 2025 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1467762302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 SW YAMHILL ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043316",
            "telephone_number": "503-523-0296",
            "fax_number": "503-523-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 NW CORNELL RD # 220",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067334",
            "telephone_number": "503-878-8885",
            "fax_number": "971-297-1360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 SW Yamhill St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972043316",
            "country_code": "US",
            "telephone_number": "503-878-8885",
            "fax_number": "503-523-0296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Executive Pkwy Ste 260",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974012199",
            "country_code": "US",
            "telephone_number": "800-828-8417",
            "fax_number": "971-297-1360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 Main St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986603136",
            "country_code": "US",
            "telephone_number": "503-878-8885",
            "fax_number": "971-297-1360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 NE Mother Joseph Pl",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643200",
            "country_code": "US",
            "telephone_number": "360-256-2000",
            "fax_number": "360-514-2458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENSON",
        "first_name": "TYANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61638009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.