Emily Renee Wittenberg

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10006239 Issued in OR

Practice address

702 Sunset Dr
Ontario, OR 97914-3121

Phone

(541) 889-9167

Fax

(541) 889-7873

NPI assigned

Nov 18, 2022

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifeways IncGroup PAC ID 4183696214, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifeways, Inc

  • Community/Behavioral Health Agency
  • Ontario, OR
  • NPI 1568558955

  ID

  Medicare reassignment Care Compare group NPD
• Lifeways, Inc

  dba Aspen Springs

  • Psychiatric Residential Treatment Facility
  • Hermiston, OR
  • NPI 1144761784
  NPD
• Lifeways, Inc

  • Community/Behavioral Health Agency
  • Pendleton, OR
  • NPI 1932295326
  NPD
• Lifeways, Inc

  dba Lifeways Hospital

  • Psychiatric Hospital
  • Boise, ID
  • NPI 1437620358
  NPD (past)

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1720797657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167",
            "fax_number": "541-889-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "EMILY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10006239",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10006239",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10006239",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202113193RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Wilson, CADC-R
• Kimberly Wilson, RDH
• Micah James Wilson, NP
• Tammie Jean Wilson, LPC
• Mark Wiseman
• Jayna Witty
• Sidni Wolery
• Keely Wolf, PA-C
• Steven Neil Wolf
• Heather Wolfe

• Psychiatric/Mental Health Nurse Practitioner in Ontario, OR
• Providers in Ontario, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.