Organization Active NPI

Pearl Health Center,PC

Doing business as Pearl Health Center

  • Adult Mental Health Clinic/Center
  • Portland, OR
National Provider Identifier
1730951674
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PEARL HEALTH CENTER,PC
Doing business as
Pearl Health Center
Practice address
933 NW 25TH Ave
Portland, OR 97210-2829
Phone
(503) 525-0090
NPI assigned
Oct 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Breanna Carson
Title
Practice Manager
Phone
(503) 525-0090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

933 NW 25TH Ave
Portland, OR 97210-2829

Mailing address

933 NW 25TH Ave
Portland, OR 97210-2829
Phone (503) 525-0090

Other practice location 1

721 NW 9th Ave Ste 100
Portland, OR 97209-3519
Phone (503) 525-0090

Other names 1

  • Pearl Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2283837Pearl Health Center933 NW 25TH, Portland, OR 97210Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory

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": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1730951674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 NW 25TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102829",
            "telephone_number": "503-525-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 NW 25TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102829",
            "telephone_number": "503-525-0090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 NW 9th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972093519",
            "country_code": "US",
            "telephone_number": "503-525-0090",
            "fax_number": "971-244-0219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEARL HEALTH CENTER,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "BREANNA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "503-525-0090"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearl Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.