Robert Timothy Pea, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11-03-70 Issued in OR

Practice address

11089 SE Westchester Ave
Happy Valley, OR 97086-7092

Phone

(503) 307-5203

NPI assigned

May 2, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1720379290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11089 SE WESTCHESTER AVE",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867092",
            "telephone_number": "503-307-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11089 SE WESTCHESTER AVE",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867092",
            "telephone_number": "503-307-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEA",
        "first_name": "ROBERT",
        "middle_name": "TIMOTHY",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-03-70",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dharti Patel
• Taylor Lee Patterson, PT, DPT
• Paula M Crone, DO PC
• Jeffrey P Pavelka, DO
• Katharine Payne, FNP
• Peaceful Care House
• Peacehealth Networks on Demand, LLC
• Anna Christine Peaslee
• Adam Peterson, QMHP
• Heather Peterson

• Addiction (Substance Use Disorder) Counselor in Happy Valley, OR
• Providers in Happy Valley, 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 May 2, 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.