Katherine A. Pedersen, CADCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1427 SE 182ND Ave.
Portland, OR 97233

Phone

(503) 761-6006

Fax

(503) 761-1434

NPI assigned

Mar 3, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1437213865

  Addiction (Substance Use Disorder)

  NPD (past)
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD (past)

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1669864468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E. BURNSIDE ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-239-8400",
            "fax_number": "503-269-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 SE 182ND AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-761-6006",
            "fax_number": "503-761-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "KATHERINE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "CADCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Elizabeth Pedego, PH.D., BCBA-D
• Marisa Quijano Peden, LMT
• Andrew Dale Pedersen, M.D.
• Eizabeth Michele Pedersen, LMT
• Joni Pedersen
• Logan Pedersen
• Lynne Marie Pedersen, DPT
• Susan K Pedersen, LMT
• Tyler Pedersen, LMT
• Ben Lawrence Pederson, M.D.

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.