Organization Active NPI

Portland Health and Wellness, LLC

  • Prescribing (Medical) Psychologist
  • Portland, OR
National Provider Identifier
1689884751
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
1224715-1 Issued in OR
Legal business name
PORTLAND HEALTH AND WELLNESS, LLC
Practice address
1821 SE Ankeny St
Portland, OR 97214-1521
Phone
(503) 236-4506
Fax
(503) 236-4501
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Joyce E Stilwell
Title
Office Manager
Phone
(503) 236-4506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X 1224715-1 OR Primary

Addresses

Primary practice location

1821 SE Ankeny St
Portland, OR 97214-1521

Mailing address

1821 SE Ankeny St
Portland, OR 97214-1521
Phone (503) 236-4506

National Provider Directory

National Provider Directory

Locations

1821 SE Ankeny St
Portland, OR 97214
Phone (503) 236-4506

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689884751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141521",
            "telephone_number": "503-236-4506",
            "fax_number": "503-236-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141521",
            "telephone_number": "503-236-4506",
            "fax_number": "503-236-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STILWELL",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-236-4506",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "OR",
            "license": "1224715-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.