Holy Family Catholic Clinic, P.S.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HOLY FAMILY CATHOLIC CLINIC, P.S.

Practice address

21810 Willamette Dr
West Linn, OR 97068-3256

Phone

(503) 994-4353

NPI assigned

Aug 10, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Jose

Title

Business Manager

Phone

(503) 994-4353

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22103/brand/1/csg/1/fhir/r4

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kara R Johansen, PSYD

  • Clinical Psychologist
  • West Linn, OR
  • NPI 1124220389
  Medicare reassignment Care Compare group NPD
• Michael G. Sherman, M.D.

  • Internal Medicine Physician
  • West Linn, OR
  • NPI 1205866589
  Medicare reassignment Care Compare group NPD
• Andrew Tistadt, PA-C

  • Medical Physician Assistant
  • West Linn, OR
  • NPI 1831269265
  Medicare reassignment Care Compare group
• Grace E Jazrawi, DO

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1720213366
  Medicare reassignment NPD
• Angela R Vinti, PHARMD, BCPS

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • West Linn, OR
  • NPI 1295721819
  NPD
• Michaela Roxana Westover, FNP-BC

  • Family Nurse Practitioner
  • Forest Grove, OR
  • NPI 1649987413
  NPD (past)

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1619588175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21810 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-994-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21810 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-994-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY FAMILY CATHOLIC CLINIC, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "503-994-4353"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Eileen Henry-McAllister, PSY.D.
• Ilene Marie Herget, RN
• Hi School Pharmacy of Oregon Inc (Hi School Pharmacy)
• Lauren Hisada, LPC, HTR
• Mingming Zhang Hohensee, OTR/L
• Jonel R Hood, PTA
• Tamara Lynn Hoogestraat, PSY.D., M.B.A.
• Gracey Louise Hook
• Bronwyn Horn
• Barbara M Houston, PSYD

• Family Medicine Physician in West Linn, OR
• Providers in West Linn, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.