NPIMap

Organization Active NPI

Native American Rehabilitation Assoc Inc

Doing business as NARA NW - Bear Lodge

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1619106945
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NATIVE AMERICAN REHABILITATION ASSOC INC
Doing business as
NARA NW - Bear Lodge
NARA NW-Totem Lodge
Practice address
3636 NE Broadway St
Portland, OR 97232-1823
Phone
(503) 548-0346
Fax
(503) 232-5959
NPI assigned
Jul 8, 2009
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Ray Dunn Jr.
Title
Payroll & Workforce Comp. Director
Phone
(971) 288-9121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3636 NE Broadway St
Portland, OR 97232-1823

Mailing address

PO Box 1569
Attention Credentialing
Portland, OR 97207-1569
Phone (503) 224-1044

Other identifiers 1

IdentifierTypeStateIssuer
126370MedicaidOR

Other names 3

  • NARA NW - Bear Lodge Doing business as
  • NARA NW-Totem Lodge Doing business as
  • NATIVE AMERICAN REHABILITATION ASSOCIATION OF THE NORTHWEST, INC. Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310001435 OR Part B Supplier - Clinic/Group Practice 2668361585 Receives reassigned benefits from 40 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Gresham, OR
O20100707000171 OR Part A Provider - Federally Qualified Health Center (FQHC) 2668361585 Practice locations: Portland, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619106945. Details of each certification follow.

Federally qualified health center certification: CCN 381921

Legal name
NATIVE AMERICAN REHABILITATION ASSOC INC
Doing business as
NARA NW
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 28, 2010
Last certification
Jul 28, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 11, 1970 in OR
Enrollment address
3636 NE Broadway St
Bear Lodge
Portland, OR 97232-1823

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Native American Rehab10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12360 E Burnside St
Portland, OR 97233
Phone (971) 279-4800

3636 NE Broadway St
Portland, OR 97232
Phone (503) 548-0346

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Norrine Smokey Smith Individual Corporate DirectorVice President Jan 1, 2010
Native American Rehabilitation Assoc Inc Organization, Portland, OR Corporation, Non-profit Operational/Managerial Control Jun 20, 1998
Jacqueline Mercer Individual Corporate DirectorCeo Jun 20, 1997
W-2 Managing EmployeeCheif Executive Officer Feb 26, 1996
Cheryl Bittle Individual Corporate DirectorBoard Member Jan 1, 2007
Cheryl Baldoramo Lucas Individual Corporate DirectorBoard Member Nov 28, 2023
Doug Barrett Individual Corporate DirectorBoard Member Apr 1, 2024
Karen Wheeler Individual Corporate DirectorTreasurer/Board Member Jan 1, 2019
Joan Onnagan Individual W-2 Managing EmployeeChief Compliance, Privacy and Risk May 13, 2024

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nara NWPortland, OR, CCN 381880 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990
Nara NW-Gresham YrtcGresham, OR, CCN 931000 Federally qualified health center Operational/Managerial Control
Other		 Oct 2, 2017
Oct 2, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1619106945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1569",
            "address_2": "ATTENTION CREDENTIALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972071569",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321823",
            "telephone_number": "503-548-0346",
            "fax_number": "503-232-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE AMERICAN REHABILITATION ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-08",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PAYROLL & WORKFORCE COMP. DIRECTOR",
        "authorized_official_telephone_number": "971-288-9121",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126370",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NARA NW - Bear Lodge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NARA NW-Totem Lodge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NATIVE AMERICAN REHABILITATION ASSOCIATION OF THE NORTHWEST, INC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.