Active NPI
Michael David Razavi, MPH, CADC I, PRC,
- Peer Specialist
- Portland, OR
National Provider Identifier
1760850549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 15-PRC-004
- Practice address
- 2054 N Vancouver Ave
Portland, OR 97227-1917 - Phone
- (503) 231-8164
- NPI assigned
- Sep 9, 2015
- 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 | 11-09-48 | OR | |
| Peer Specialist | 175T00000X | 15-PRC-004 | OR | Primary |
Addresses
Primary practice location
2054 N Vancouver Ave
Portland, OR 97227-1917
Mailing address
2054 N Vancouver Ave
Portland, OR 97227-1917
Phone (503) 231-8164
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 |
|---|---|---|---|
| 15-PRC-004 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1760850549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2054 N VANCOUVER AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271917",
"telephone_number": "503-231-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2054 N VANCOUVER AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271917",
"telephone_number": "503-231-8164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZAVI",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"credential": "MPH, CADC I, PRC,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-09",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "11-09-48",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "15-PRC-004",
"primary": true
}
],
"identifiers": [],
"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 Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.