Individual provider Active NPI

Laura Wavrunek

  • Clinical Social Worker
  • Hood River, OR
National Provider Identifier
1770315517
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L15137 Issued in OR
Practice address
1204 Montello Ave
Hood River, OR 97031-1551
Phone
(541) 399-5142
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L15137 OR Primary

Addresses

Primary practice location

1204 Montello Ave
Hood River, OR 97031-1551

Mailing address

1204 Montello Ave
Hood River, OR 97031-1551

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
I20260423001398 OR Practitioner - Clinical Social Worker 8426525890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Front St
Suite 300
Jupiter, FL 33477-5095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L15137ORMDClinical Social Worker

Organizations & group practices 2

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1770315517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MONTELLO AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MONTELLO AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311551",
            "telephone_number": "541-399-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAVRUNEK",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L15137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.