Active NPI
Raizie R Axman, LPC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1740359769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C0229
- Practice address
- 3434 SW Kelly Ave
Portland, OR 97239-4630 - Phone
- (503) 245-8633
- Fax
- (503) 892-2429
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C0229 | OR | Primary |
Addresses
Primary practice location
3434 SW Kelly Ave
Portland, OR 97239-4630
Mailing address
8870 SW Oak LN
Portland, OR 97223-7285
Phone (503) 245-8633
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0252450000 | Other | OR | REGENCE BCBS OF OREGON |
| 112232 | Other | OR | KAISER PERMANENTE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0229 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740359769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8870 SW OAK LN",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972237285",
"telephone_number": "503-245-8633",
"fax_number": "503-892-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 SW KELLY AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394630",
"telephone_number": "503-245-8633",
"fax_number": "503-892-2429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AXMAN",
"first_name": "RAIZIE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C0229",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BCBS OF OREGON",
"identifier": "0252450000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "112232",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.