Active NPI
NW Mind-Body Wellness, LLC
- Psychiatric/Mental Health Nurse Practitioner
- Salem, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 201406327NP-PP
- Legal business name
- NW MIND-BODY WELLNESS, LLC
- Practice address
- 945 Columbia St NE
Salem, OR 97301-7205 - Phone
- (503) 707-1950
- Fax
- (855) 461-3306
- NPI assigned
- Jan 2, 2018
- Last updated
- Jul 30, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rebecca Dorsey, APRN
- Title
- Owner / Provider
- Phone
- (503) 707-1950
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201406327NP-PP | OR | Primary |
Addresses
Primary practice location
945 Columbia St NE
Salem, OR 97301-7205
Mailing address
945 Columbia St NE
Salem, OR 97301-7205
Phone (503) 707-1950
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2210227 | NW Mind-Body Wellness | Certificate of waiver | Jan 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
945 Columbia St NE
Salem, OR 97301
Phone (503) 707-1950
30300 SW Parkway Ave
Wilsonville, OR 97070
Phone (503) 707-1950
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Salem, OR
- NPI 1770984841
-
- Mental Health Counselor
- Albany, OR
- NPI 1356775050
-
- Professional Counselor
- Tigard, OR
- NPI 1730548215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722297600000",
"number": "1467969220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 COLUMBIA ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973017205",
"telephone_number": "503-707-1950",
"fax_number": "855-461-3306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 COLUMBIA ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973017205",
"telephone_number": "503-707-1950",
"fax_number": "855-461-3306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NW MIND-BODY WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-02",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A",
"authorized_official_last_name": "DORSEY",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "OWNER / PROVIDER",
"authorized_official_telephone_number": "503-707-1950",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "201406327NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.