Individual provider Active NPI

Alisa Farrell

  • Counselor
  • Portland, OR
National Provider Identifier
1558082347
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2375 NW Glisan St
Portland, OR 97210-3420
Phone
(503) 927-0384
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

2375 NW Glisan St
Portland, OR 97210-3420

Mailing address

57679 NW Johansen LN
Gales Creek, OR 97117-9382
Phone (971) 200-0117

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

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1558082347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57679 NW JOHANSEN LN",
            "city": "GALES CREEK",
            "state": "OR",
            "postal_code": "971179382",
            "telephone_number": "971-200-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 NW GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103420",
            "telephone_number": "503-927-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "ALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 8, 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.