Myron John Welbes, CADC I, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

13-CRM-075 Issued in OR

Practice address

17663 SE 82ND Drive
Gladstone, OR 97027

Phone

(503) 344-6710

NPI assigned

Feb 15, 2007

Last updated

Jul 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1578606935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17036 S EADEN RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970458673",
            "telephone_number": "503-915-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17663 SE 82ND DRIVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "97027",
            "telephone_number": "503-344-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBES",
        "first_name": "MYRON",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CADC I, CRM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "06-07-48",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "13-CRM-075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.