Active NPI
Vanessa Lynn Washington, LPC
- Professional Counselor
- Portland, OR
National Provider Identifier
1548540545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 511 SW 10TH Ave Ste 1104
Portland, OR 97205-2712 - Phone
- (503) 444-8214
- Fax
- (888) 978-8164
- NPI assigned
- Aug 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C3358 | OR | |
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
511 SW 10TH Ave Ste 1104
Portland, OR 97205-2712
Mailing address
511 SW 10TH Ave Ste 1104
Portland, OR 97205-2712
Phone (503) 444-8214
Other practice location 1
712 SE Hawthorne Blvd
Ste 100
Portland, OR 97214-3538
Phone (503) 954-2188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500669881 | Medicaid | OR |
Other names 1
- Vanessa Lynn Marks
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3358 | OR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sankofa Counseling, LLC | Professional | Current | Accepting new patients |
Locations
5014 NE 15th Ave
Portland, OR 97211
Phone (503) 389-5646
511 SW 10th Ave
Ste 1104
Portland, OR 97205
Phone (503) 444-8214
Organizations & group practices 1
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.
-
- Professional Counselor
- Portland, OR
- NPI 1851842108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1548540545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 SW 10TH AVE STE 1104",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972052712",
"telephone_number": "503-444-8214",
"fax_number": "888-978-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 SW 10TH AVE STE 1104",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972052712",
"telephone_number": "503-444-8214",
"fax_number": "888-978-8164"
}
],
"practiceLocations": [
{
"address_1": "712 SE Hawthorne Blvd",
"address_2": "STE 100",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972143538",
"country_code": "US",
"telephone_number": "503-954-2188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WASHINGTON",
"first_name": "VANESSA",
"middle_name": "LYNN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C3358",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500669881",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VANESSA",
"last_name": "MARKS",
"middle_name": "LYNN",
"credential": "MA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.