Active NPI
Sherwin H. Moscow, MA
- Addiction (Substance Use Disorder) Counselor
- Gresham, OR
National Provider Identifier
1760595441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- OR88-09-01
- Practice address
- 1550 NW Eastman Pkwy
Gresham, OR 97030-3858 - Phone
- (503) 571-0725
- Fax
- (503) 571-0720
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | OR88-09-01 | OR | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP00005723 | WA |
Addresses
Primary practice location
1550 NW Eastman Pkwy
Gresham, OR 97030-3858
Mailing address
5264 NE 121St Ave Apt 315
Vancouver, WA 98682-2160
Phone (360) 828-5844
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP00005723 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760595441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5264 NE 121ST AVE APT 315",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986822160",
"telephone_number": "360-828-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 NW EASTMAN PKWY",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303858",
"telephone_number": "503-571-0725",
"fax_number": "503-571-0720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSCOW",
"first_name": "SHERWIN",
"middle_name": "H.",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "OR88-09-01",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP00005723",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gresham, 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.