Individual provider Active NPI

Samantha Anne Stofiel, CRM, PSS

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1780403105
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
24-CRM-3543 Issued in OR
Practice address
10209 SE Division St BLDG C
Portland, OR 97266-1372
Phone
(503) 228-9229
Fax
(502) 228-9558
NPI assigned
Oct 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 24-CRM-3543 OR Primary

Addresses

Primary practice location

10209 SE Division St BLDG C
Portland, OR 97266-1372

Mailing address

3650 NE Mallory Ave Apt 202
Portland, OR 97212-3085
Phone (971) 985-2225

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

LicenseStateTypeSpecialty
24-CRM-3543ORMDPeer Specialist

Interoperability endpoints

  • Direct secure messaging: samantha.stofiel.p1@direct.voaor.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1780403105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 NE MALLORY AVE APT 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123085",
            "telephone_number": "971-985-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10209 SE DIVISION ST BLDG C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661372",
            "telephone_number": "503-228-9229",
            "fax_number": "502-228-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOFIEL",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "credential": "CRM, PSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "24-CRM-3543",
            "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 Oct 3, 2024; 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.