NPIMap

Organization Active NPI

Lifespan Psychiatric Consulting, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1487191797
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
20070075NP Issued in OR
Legal business name
LIFESPAN PSYCHIATRIC CONSULTING, LLC
Practice address
955 NE 3Rd St
Gresham, OR 97030-7418
Phone
(503) 491-5896
Fax
(888) 972-9783
NPI assigned
Jan 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Mr. Andrew Vilius, PMHNP
Title
Owner / Principal
Phone
(503) 491-5896

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 20070075NP OR Primary

Addresses

Primary practice location

955 NE 3Rd St
Gresham, OR 97030-7418

Mailing address

955 NE 3Rd St
Gresham, OR 97030-7418
Phone (503) 491-5896

National Provider Directory

National Provider Directory

Locations

320 N Main Ave
Ste 209
Gresham, OR 97030

955 NE 3rd St
Gresham, OR 97030
Phone (503) 465-5941

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1487191797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 NE 3RD ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307418",
            "telephone_number": "503-491-5896",
            "fax_number": "888-972-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 NE 3RD ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307418",
            "telephone_number": "503-491-5896",
            "fax_number": "888-972-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN PSYCHIATRIC CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "VILIUS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER / PRINCIPAL",
        "authorized_official_telephone_number": "503-491-5896",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "20070075NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.