MTN. Retreat Secured Transport

Primary specialty

Secured Medical Transport (VAN)Taxonomy code 343800000X

Legal business name

MTN. RETREAT SECURED TRANSPORT

Practice address

929 NE 181St Ave.
Suite a
Portland, OR 97230

Phone

(503) 666-9895

Fax

(503) 666-8165

NPI assigned

Oct 2, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Robert Kenneth Rapoza

Title

President

Phone

(503) 666-9895

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Thora Enterprises, Inc. Other name

Locations

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1801121256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 16157",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97292",
            "telephone_number": "503-666-9895",
            "fax_number": "503-666-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 NE 181ST AVE.",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-666-9895",
            "fax_number": "503-666-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTN. RETREAT SECURED TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "RAPOZA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-666-9895",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILD WELFARE",
            "identifier": "DHS128560",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9046814",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116090",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thora Enterprises, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mt. Tabor Family Medical Group, PC
• Mta Homes at St. Andrews LLC
• Kristine Mua, RN
• Michelle Much, RN
• Tamara Jane Mucha, MPT
• Skyler Allan Muchmore
• Janet Lee Muckridge, RD LD

• Secured Medical Transport (VAN) in Portland, OR
• Providers in Portland, OR by specialty
• Secured Medical Transport (VAN) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; 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.