Marina Banderas, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

THW000109713 Issued in OR

Practice address

1174 Cornucopia St NW Ste 240
Salem, OR 97304-3193

Phone

(971) 301-4411

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21276/brand/1/csg/1/fhir/r4

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.

• Well Life Family Medicine, LLC

  • Clinic/Center
  • Salem, OR
  • NPI 1760998355
  NPD
• Clear Choice Dermatology

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185
  NPD (past)

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1508638958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 FALCON VIEW WAY NE APT 203",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973052283",
            "telephone_number": "971-407-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 CORNUCOPIA ST NW STE 240",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043193",
            "telephone_number": "971-301-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDERAS",
        "first_name": "MARINA",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW000109713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Timothy Balmer, MD
• Barbara M Balowitz, LCSW
• Bamboo Garden One LLC
• Susan Bamford, LCSW
• Magdalena Janina Banasiak, MD
• Ann-Marie Johnston Bandfield, MSW
• Nicole J Bangs, P.A.-C.
• Nghia Banh
• Aaron Banker, PMHNP
• Terry Denise Banta, CSWA

• Community Health Worker in Salem, OR
• Providers in Salem, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.