Individual provider Active NPI

Romanet Leiva Flores Coleman

  • Community Health Worker
  • Milwaukie, OR
National Provider Identifier
1639926256
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
109580 Issued in OR
Practice address
10202 SE 32ND Ave Ste 101
Milwaukie, OR 97222-3611
Phone
(503) 705-7970
NPI assigned
May 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 109580 OR Primary

Addresses

Primary practice location

10202 SE 32ND Ave Ste 101
Milwaukie, OR 97222-3611

Mailing address

10202 SE 32ND Ave Ste 101
Milwaukie, OR 97222-3611
Phone (503) 705-7970

Other names 1

  • Romanet Leiva Flores Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109580ORMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1639926256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE STE 101",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223611",
            "telephone_number": "503-705-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE STE 101",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223611",
            "telephone_number": "503-705-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ROMANET",
        "middle_name": "LEIVA FLORES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "109580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROMANET",
            "last_name": "LEIVA FLORES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.