Corvallis Homeless Shelter Coalition

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

CORVALLIS HOMELESS SHELTER COALITION

Doing business as

Corvallis Housing First

Practice address

2311 NW Van Buren Ave
Corvallis, OR 97330-5399

Phone

(541) 230-1297

Fax

(541) 368-3902

NPI assigned

Apr 23, 2018

Last updated

Jan 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Myhre

Title

Executive Director

Phone

(541) 602-8502

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Corvallis Housing First Doing business as

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Boseck

  • Community Health Worker
  • Corvallis, OR
  • NPI 1679335921
  NPD
• Tamara R McClaskey

  • Community Health Worker
  • Corvallis, OR
  • NPI 1649032988
  NPD
• Madeline Marie Miller

  • Peer Specialist
  • Corvallis, OR
  • NPI 1306617329
  NPD
• Dan Easdale

  • Community Health Worker
  • Corvallis, OR
  • NPI 1306617337
  NPD (past)
• Jordan Taylor Horrell, CPCO

  • Physician Office Based Coding Specialist
  • Corvallis, OR
  • NPI 1881182178
  NPD (past)
• Tatiana Leon

  • Community Health Worker
  • Corvallis, OR
  • NPI 1568391084
  NPD (past)
• Jennifer Larisa McDermond, QMHA

  • Case Manager/Care Coordinator
  • Corvallis, OR
  • NPI 1790275881
  NPD (past)

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1689162976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 NW VAN BUREN AVE APT 5",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305393",
            "telephone_number": "541-230-1297",
            "fax_number": "541-368-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 NW VAN BUREN AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305399",
            "telephone_number": "541-230-1297",
            "fax_number": "541-368-3902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 NW Harrison Blvd",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305755",
            "country_code": "US",
            "telephone_number": "541-230-1297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2311 NW Van Buren Ave Apt 5",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305393",
            "country_code": "US",
            "telephone_number": "541-230-1297",
            "fax_number": "541-368-3902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1480 SW 3rd St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973331241",
            "country_code": "US",
            "telephone_number": "541-230-1297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 NW Dixon St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973304668",
            "country_code": "US",
            "telephone_number": "541-230-1297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORVALLIS HOMELESS SHELTER COALITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "MYHRE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-602-8502"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435001-98",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvallis Housing First",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Health Worker in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.