Steven Wade

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW1630 Issued in OR

Practice address

4512 NE Portland Hwy
Portland, OR 97218-1363

Phone

(503) 935-1513

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Healing Minds Healing Unity Training & Dev

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1881554145
  NPD Authorized official
• HM-Hu

  • Peer Specialist
  • Portland, OR
  • NPI 1033607494
  NPD (past) Authorized official

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1750886255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 NE PORTLAND HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181363",
            "telephone_number": "503-935-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 NE PORTLAND HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181363",
            "telephone_number": "503-935-1513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4512 NE Portland Hwy",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972181363",
            "country_code": "US",
            "telephone_number": "503-935-1513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW1630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEER SUPPORT SPECIALIST",
            "identifier": "THW1630",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEER SERVICES",
            "identifier": "THW1630",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THW1630",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrell Wade
• Dodi L Wade, MSN, PNP
• Elizabeth Louise Wade, ND
• Jessica Wade
• Paula Renee Wade, LCSW
• Tajuana L Wade, MA
• Tyler Dean Wade
• Alexandra Marie Wadford, FNP
• Brian D Wadley, M.D.
• Jenny Lynn Wadman, PT

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.