Elizabeth Bodenner

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6011 NE Oregon St
Portland, OR 97213-4300

Phone

(971) 319-4827

Fax

(503) 662-6221

NPI assigned

Oct 3, 2019

Last updated

Dec 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Sprout Therapy PDX LLC

  dba Sprout Therapy PDX

  • Counselor
  • Portland, OR
  • NPI 1093346777
  NPD

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1477194181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9133 N ALLEGHENY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972032303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 NE OREGON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134300",
            "telephone_number": "971-319-4827",
            "fax_number": "503-662-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENNER",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samara Cristina Bockelman
• Carol Christine Bockemehl, RN
• Kathryn Leigh Bodden, ND
• Roberta J Boden, RN
• Stephanie Cardella Boden
• Talia Julien Bodi
• Sarah Elizabeth Bodian, RN
• Jack S Bodily
• Cole Michael Bodine, PHARMD
• Stacy Marie Bodle, LPN

• Student in an Organized Health Care Education/Training Program in Portland, OR
• Providers in Portland, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.