Individual provider Active NPI

Isabel Avidan Hart, CHW

  • Community Health Worker
  • Portland, OR
National Provider Identifier
1801502612
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
THW000108194 Issued in OR
Practice address
721 NW 9TH Ave Ste 100
Portland, OR 97209-3519
Phone
(503) 525-0090
Fax
(971) 244-0219
NPI assigned
Jan 25, 2023
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X THW000108194 OR Primary

Addresses

Primary practice location

721 NW 9TH Ave Ste 100
Portland, OR 97209-3519

Mailing address

721 NW 9TH Ave Ste 100
Portland, OR 97209-3519
Phone (503) 525-0090

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
THW000108194ORMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1801502612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 NW 9TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093519",
            "telephone_number": "503-525-0090",
            "fax_number": "971-244-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 NW 9TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093519",
            "telephone_number": "503-525-0090",
            "fax_number": "971-244-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "ISABEL",
        "middle_name": "AVIDAN",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW000108194",
            "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 Jan 25, 2023; 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.