Alexandra Ryan Mattingly, QMHA-R

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

23-QMHA-R-4281 Issued in OR

Practice address

12360 E Burnside St
Portland, OR 97233-1042

Phone

(971) 279-4800

Fax

(971) 279-2051

NPI assigned

Aug 16, 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

Other identifiers 1

Other names 1

• Alex Ryan Mattingly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1518740232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331042",
            "telephone_number": "971-279-4800",
            "fax_number": "971-279-2051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 NE 2nd St",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970307514",
            "country_code": "US",
            "telephone_number": "971-274-3757",
            "fax_number": "503-912-5740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "ALEXANDRA",
        "middle_name": "RYAN",
        "credential": "QMHA-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHA-R-4281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500824476",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "MATTINGLY",
            "middle_name": "RYAN",
            "credential": "QMHA-R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Timothy Ira Matthews
• Sharlene Matthieu, M.D.
• John Matti
• Vera Matti
• Elizabeth C Mattia, MA, NCC
• Irena Mattingly, AGNP-C
• Anne E Mattis, RN
• Steven J Mattison, MD
• Tracy Ann Mattner, LMT
• Mikel Matto, M.D.

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.