Individual provider Active NPI

Emmylou Boyle

  • Clinical Social Worker
  • Oregon City, OR
National Provider Identifier
1558426916
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4450 Issued in OR
Practice address
998 Library CT
Oregon City, OR 97045-4041
Phone
(503) 655-8401
Fax
(503) 655-8429
NPI assigned
Dec 26, 2006
Last updated
Jul 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L4450 OR Primary

Addresses

Primary practice location

998 Library CT
Oregon City, OR 97045-4041

Mailing address

998 Library CT
Oregon City, OR 97045-4041
Phone (503) 655-8401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090706000662 OR Practitioner - Clinical Social Worker 8820149792 Reassigns benefits to 1 organization
I20230601002582 WA Practitioner - Clinical Social Worker 8820149792 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L4450ORMDClinical Social Worker
4450ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Apr 12, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Apr 12, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Apr 12, 2023 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients
Clackamas County Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

19185 SW 90th Ave
Tualatin, OR 97062
Phone (503) 723-6699

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1558426916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401",
            "fax_number": "503-655-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401",
            "fax_number": "503-655-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "EMMYLOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.