Active NPI
Michele A Pinkham, PSS
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1780136606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- THW0001621
- Practice address
- 1631 SW Columbia St
Portland, OR 97201-6025 - Phone
- (503) 231-2641
- Fax
- (503) 231-1654
- NPI assigned
- Oct 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | THW0001621 | OR | Primary |
Addresses
Primary practice location
1631 SW Columbia St
Portland, OR 97201-6025
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Phone (971) 386-2278
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500729104 | Medicaid | OR |
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 |
|---|---|---|---|
| THW0001621 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780136606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 SW MADISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051715",
"telephone_number": "971-386-2278",
"fax_number": "503-224-4494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 SW COLUMBIA ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972016025",
"telephone_number": "503-231-2641",
"fax_number": "503-231-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINKHAM",
"first_name": "MICHELE",
"middle_name": "A",
"credential": "PSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "THW0001621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500729104",
"state": "OR"
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.