Active NPI
Brooke Bass
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1699587014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- R10567
- Practice address
- 1962 NW Kearney St Ste 302
Portland, OR 97209-1464 - Phone
- (504) 458-6157
- NPI assigned
- Jan 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | R10567 | OR | Primary |
Addresses
Primary practice location
1962 NW Kearney St Ste 302
Portland, OR 97209-1464
Mailing address
13050 Fielding Rd
Lake Oswego, OR 97034-2413
Phone (504) 458-6157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R10567 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1699587014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13050 FIELDING RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970342413",
"telephone_number": "504-458-6157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1962 NW KEARNEY ST STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091464",
"telephone_number": "504-458-6157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "BROOKE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-22",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "R10567",
"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 Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.