Active NPI
Cheri Tynan I
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1659828184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 175T00000X
- Practice address
- 7934 S/E Knight St
Portland, OR 97206-5859 - Phone
- (971) 832-0672
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 175T00000X | OR | Primary |
Addresses
Primary practice location
7934 S/E Knight St
Portland, OR 97206-5859
Mailing address
7934 SE Knight St
Portland, OR 97206-5859
Phone (971) 832-0672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175T00000X | Other | OR | PEER SUPPORT SPECALIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 175T00000X | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1659828184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7934 SE KNIGHT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972065859",
"telephone_number": "971-832-0672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7934 S/E KNIGHT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972065859",
"telephone_number": "971-832-0672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYNAN",
"first_name": "CHERI",
"name_suffix": "I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "175T00000X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEER SUPPORT SPECALIST",
"identifier": "175T00000X",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.