Dylan Weeratunge, CADC CANDIDATE/QMHA

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

847 NE 19TH Ave Ste 100
Portland, OR 97232

Phone

(503) 238-0769

NPI assigned

Oct 7, 2016

Last updated

Jun 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1538619069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-238-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEERATUNGE",
        "first_name": "DYLAN",
        "credential": "CADC CANDIDATE/QMHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-17-256",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500724989",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Weeks, BA, MA
• Shannon Weeks, N.D.
• Virginia Clare Weeks, MD
• Christine Hang-Bok Weer
• Upekha Weerasinghe
• Janet Marie Weerts, RN
• Lauren Weerts, CCC-SLP
• Alexandria Marie Weets
• Erryn Weggenman, PHYSICIAN ASSISTANT
• James Robert Weggenman, PT

• Adult Companion in Portland, OR
• Providers in Portland, OR by specialty
• Adult Companion in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.