Ketki Patankar, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C6743 Issued in OR

Practice address

9155 SW Barnes Rd Ste 205
Portland, OR 97225-6629

Phone

(503) 216-2025

NPI assigned

Apr 4, 2018

Last updated

Sep 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1467958777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256629",
            "telephone_number": "503-216-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256629",
            "telephone_number": "503-216-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1049 SW Baseline St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971233835",
            "country_code": "US",
            "telephone_number": "503-473-1154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATANKAR",
        "first_name": "KETKI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Pastor
• Mariel Pastor, MA
• Fiona Pat
• Brianna Sue Patacini, PHARMD
• Alyssa Pataki, LMFT
• Pate Acupuncture & Chinese Medicine
• Ainsley Grace Pate, PA-C
• Brittany Pate
• Christopher Pate
• Cynthia A Pate, MASSAGE THERAPIST

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.