Individual provider Active NPI

Andrew Decker

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1740837012
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T2097 Issued in OR
Practice address
19500 SE Stark St
Portland, OR 97233-5757
Phone
(800) 813-2000
NPI assigned
Aug 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X T2097 OR Primary

Addresses

Primary practice location

19500 SE Stark St
Portland, OR 97233-5757

Mailing address

500 NE Multnomah St FL 11
Portland, OR 97232-2023

Other practice location 1

1175 E Main St Ste C1
Medford, OR 97504-7457
Phone (541) 772-0127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321001515 OR Practitioner - Marriage and Family Therapist 6901328715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T2097ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade AIDS Project CurrentSince Jan 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 30, 2025 Accepting new patients
Cascade AIDS Project CurrentSince Jan 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 30, 2025 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

19500 SE Stark St
Portland, OR 97233
Phone (503) 669-3900

500 NE Multnomah St
Fl 11
Portland, OR 97232

2236 SE Belmont St
Portland, OR 97214
Phone (503) 445-7699

520 NW Davis St
Ste 215
Portland, OR 97209
Phone (503) 223-5907

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1740837012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST FL 11",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335757",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 E Main St Ste C1",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975047457",
            "country_code": "US",
            "telephone_number": "541-772-0127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECKER",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "T2097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.