Individual provider Active NPI

Dianna Kay Bowlen, MSW, LCSW

  • Clinical Social Worker
  • Scappoose, OR
National Provider Identifier
1699065284
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3223 Issued in OR
Practice address
51577 SE 2ND St Apt 1203
Scappoose, OR 97056-4562
Phone
(503) 997-7734
NPI assigned
Apr 15, 2011
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X L3223 OR Primary

Addresses

Primary practice location

51577 SE 2ND St Apt 1203
Scappoose, OR 97056-4562

Mailing address

51577 SE 2ND St Apt 1203
Scappoose, OR 97056-4562
Phone (503) 997-7734

Other names 1

  • Dianna Kay Kingdon Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231229001228 OR Practitioner - Clinical Social Worker 0244680486 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3223ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Dec 14, 2023 Accepting new patients
A Season for Change Past Accepting new patients

Locations

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1699065284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51577 SE 2ND ST APT 1203",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564562",
            "telephone_number": "503-997-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51577 SE 2ND ST APT 1203",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564562",
            "telephone_number": "503-997-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLEN",
        "first_name": "DIANNA",
        "middle_name": "KAY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNA",
            "last_name": "KINGDON",
            "middle_name": "KAY",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scappoose, OR

Sources for this page

Verify at the official NPI Registry.