Paul Modesitt, CADC1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

900 Main St Ste 200
Oregon City, OR 97045-1869

Phone

(971) 386-3401

Fax

(503) 723-6653

NPI assigned

Feb 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1699276550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 MAIN ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451815",
            "telephone_number": "503-655-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 200",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451869",
            "telephone_number": "971-386-3401",
            "fax_number": "503-723-6653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "706 Main St",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451815",
            "country_code": "US",
            "telephone_number": "503-655-1029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODESITT",
        "first_name": "PAUL",
        "credential": "CADC1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "17-CRM-187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ames Milligan, OTR/L
• Gayle Miner
• Heather Mirenda
• Kelli N Mitchell, NCC
• Tyler Scott Mittelstaedt, MD-MPH
• Nanea Ikeahonuiokamaile Moke-Rabang
• Tessa J Molter, PAC
• Linda M Monk, LMFT
• Damariz O Montiel
• Dana R Moody, RDH, BS

• Addiction (Substance Use Disorder) Counselor in Oregon City, OR
• Providers in Oregon City, 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 Jan 6, 2022; 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.