NPIMap

Organization Active NPI

Lukedorf

  • Mental Illness Community Based Residential Treatment Facility
  • Gresham, OR
National Provider Identifier
1710271861
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
LUKEDORF
Practice address
360 SW 6TH St
Gresham, OR 97080-9475
Phone
(503) 726-3806
NPI assigned
Jun 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Authorized official

Name
Ms. Megan Wiegel
Title
HR
Phone
(503) 726-3698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

360 SW 6TH St
Gresham, OR 97080-9475

Mailing address

10313 69TH Ave
Tigard, OR 97223
Phone (503) 726-3806

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1710271861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10313 69TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-726-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SW 6TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970809475",
            "telephone_number": "503-726-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKEDORF",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "WIEGEL",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "503-726-3698",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.