Judith Anne Laue, LMT, CCA

Individual provider Active NPI Community Health Worker · Portland, OR

NPI 1598100554 · NPPES record last updated Aug 30, 2013

Key facts

NPI
1598100554
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
20016 (OR)
Practice address
3716 SE International Way
Portland, OR 97222-6001
Phone
(503) 659-0073
NPI assigned
May 5, 2013
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
20016ORMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Keith D. Johns D.C., P.C. Past
since May 14, 2008
Accepting new patients
Milwaukie Chiropractic Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 20016 OR Yes

Addresses

Primary practice location

3716 SE International Way
Portland, OR 97222-6001

Mailing address

10245 SE Bell Ave
Portland, OR 97222-2228
Phone (970) 946-7727

Other providers in Portland, OR

All providers in Portland, OR · Community Health Worker in Oregon

Sources for this page

Verify at the official NPI Registry.