Northwest Habilitation Services, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

NORTHWEST HABILITATION SERVICES, LLC

Practice address

3880 SE 8TH Ave Ste 110
Portland, OR 97202-3772

Phone

(503) 284-4440

NPI assigned

Apr 19, 2021

Organization subpart

No

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

Authorized official

Name

Andy Delahunty

Title

Ceo

Phone

(801) 319-4054

Specialties & licenses 1

Addresses

Electronic endpoints 3

Locations

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1700467966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-284-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-284-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "DELAHUNTY",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-319-4054"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.hwcg.com",
            "affiliation": "N",
            "address_1": "3880 SE 8th Ave Ste 110",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972023772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.hwcg.com",
            "affiliation": "N",
            "address_1": "3880 SE 8th Ave Ste 110",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972023772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.nw-hab.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3880 SE 8th Ave Ste 110",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972023772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community Health Worker in Portland, OR
• Providers in Portland, 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 Apr 19, 2021; 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.