NPIMap

Organization Active NPI

Oregon Wellness Network LLC

  • Health Educator
  • Keizer, OR
National Provider Identifier
1598256281
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
OREGON WELLNESS NETWORK LLC
Practice address
3410 Cherry Ave NE
Keizer, OR 97303
Phone
(503) 304-3655
NPI assigned
May 29, 2018
Last updated
Jan 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
OREGON ASSOCIATION OF AREA AGENCIES ON AGING & DISABILITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Authorized official

Name
Lavinia GotoNPI 1932473618
Title
Operations Manager
Phone
(503) 304-3408

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Diabetes Educator Registered Nurse 163WD0400X NU
Case Management Agency 251B00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Physical Therapy Clinic/Center 261QP2000X NU
Health Educator 174H00000X NU Primary

Addresses

Primary practice location

3410 Cherry Ave NE
Keizer, OR 97303

Mailing address

3410 Cherry Ave NE
Keizer, OR 97303-4924
Phone (503) 304-3408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181002001951 OR MDPP Supplier - in-Person MDPP Supplier 7719239714 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Enterprise, OR; Tillamook, OR; Silverton, OR; Salem, OR; Saint Helens, OR; Roseburg, OR; Monmouth, OR; Keizer, OR…
O20200319002694 OR Part B Supplier - Clinic/Group Practice 7719239714 Receives reassigned benefits from 4 practitioners
Practice locations: Keizer, OR; Roseburg, OR; Springfield, OR; Tillamook, OR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

702 NW 1st St
Enterprise, OR 97828
Phone 5419633186 ext. 1015

180 Warren St S
Monmouth, OR 97361
Phone (503) 838-5678

1036 SE Douglas Ave
Roseburg, OR 97470
Phone (541) 440-4235

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

610 Stillwell Ave
Tillamook, OR 97141
Phone (503) 842-9622

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1598256281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034924",
            "telephone_number": "503-304-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "97303",
            "telephone_number": "503-304-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON WELLNESS NETWORK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OREGON ASSOCIATION OF AREA AGENCIES ON AGING & DISABILITIES",
        "enumeration_date": "2018-05-29",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "GOTO",
        "authorized_official_first_name": "LAVINIA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "503-304-3408"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.