Individual provider Active NPI

Joanna Waldner

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1770952590
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
14600 NW Cornell Rd
Portland, OR 97229-5442
Phone
(503) 645-3581
Fax
(503) 629-8517
NPI assigned
Sep 22, 2015
Last updated
Oct 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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 NU Primary

Addresses

Primary practice location

14600 NW Cornell Rd
Portland, OR 97229-5442

Mailing address

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

Other practice location 1

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

Other practice location 2

1200 NW Marshall St Ste 4230
Portland, OR 97209-3192
Phone (505) 249-5141

Other names 1

  • Joanna Richards Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1770952590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14600 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442",
            "telephone_number": "503-645-3581",
            "fax_number": "503-629-8517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 SE Cesar E Chavez Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972143216",
            "country_code": "US",
            "telephone_number": "503-231-7480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 NW Marshall St Ste 4230",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972093192",
            "country_code": "US",
            "telephone_number": "505-249-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDNER",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "RICHARDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 17, 2019; 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.