Willa Bean Jutzi Shaw, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C9732 Issued in OR

Practice address

917 SW Oak St Ste 417
Portland, OR 97205-2807

Phone

(971) 385-4702

Fax

(971) 328-4653

NPI assigned

Aug 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Willa Jutzi Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neighborhood Health CenterGroup PAC ID 8426227893, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1174820815
  Medicare reassignment Care Compare group
• Vista Counseling & Consultation, Inc.

  • Community/Behavioral Health Agency
  • Eugene, OR
  • NPI 1275864985
  Medicare reassignment NPD
• Wildflower Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1487592556
  NPD Authorized official

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772928000000",
    "number": "1659009306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 SW OAK ST STE 417",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052807",
            "telephone_number": "971-385-4702",
            "fax_number": "971-328-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 SW OAK ST STE 417",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052807",
            "telephone_number": "971-385-4702",
            "fax_number": "971-328-4653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 NE Irving St Ste 440",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972324208",
            "country_code": "US",
            "telephone_number": "541-517-9733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "WILLA",
        "middle_name": "BEAN JUTZI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2026-03-08",
        "certification_date": "2026-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C9732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLA",
            "last_name": "JUTZI",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michaela Shaw
• Nicole Shaw
• Serena Shaw
• Tatyana Evgenieva Shaw, M.D.
• Teresa Shaw, RN
• Shawit Medical Transportation
• Erin R Shawn, ANP
• Jennifer Shawn, DMD
• Shawna Parsley Counseling, LLC
• Shawnte Yates, ND, Lac, LLC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.