Organization Active NPI

Weisser Wellness, LLC

  • Clinical Social Worker
  • The Dalles, OR
National Provider Identifier
1710596879
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WEISSER WELLNESS, LLC
Practice address
1210 Dry Hollow Rd Ste 6
The Dalles, OR 97058-3167
Phone
(541) 340-4076
NPI assigned
Jul 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Rachel Weisser, LCSWNPI 1356786362
Title
Owner
Phone
(541) 340-4076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1210 Dry Hollow Rd Ste 6
The Dalles, OR 97058-3167

Mailing address

1210 Dry Hollow Rd Ste 6
The Dalles, OR 97058-3167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200909001632 OR Part B Supplier - Clinic/Group Practice 1658799564 Receives reassigned benefits from 1 practitioner
Practice locations: The Dalles, OR

National Provider Directory

National Provider Directory

Locations

1210 Dry Hollow Rd
Ste 6
The Dalles, OR 97058
Phone (415) 645-3505

Practitioners & affiliated clinicians

Practitioners 1

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": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1710596879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 DRY HOLLOW RD STE 6",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 DRY HOLLOW RD STE 6",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583167",
            "telephone_number": "541-340-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEISSER WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "WEISSER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-340-4076",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.