Individual provider Active NPI

Joshua Lewis Poitra, CRM/PSS

  • Addiction (Substance Use Disorder) Counselor
  • Gresham, OR
National Provider Identifier
1821780669
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
22-CRM-1438 Issued in OR
Practice address
355 NW Division St
Gresham, OR 97030-5523
Phone
(971) 225-6695
Fax
(503) 231-1654
NPI assigned
May 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X THW000107988 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 22-CRM-1438 OR Primary

Addresses

Primary practice location

355 NW Division St
Gresham, OR 97030-5523

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044

Other practice location 1

1631 SW Coumbia St
Portland, OR 97201
Phone (503) 231-2641

Other identifiers 1

IdentifierTypeStateIssuer
500820235MedicaidOR

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
22-CRM-1438ORMDAddiction (Substance Use Disorder) Counselor
THW000107988ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1821780669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305523",
            "telephone_number": "971-225-6695",
            "fax_number": "503-231-1654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1631 SW COUMBIA ST",
            "address_purpose": "LOCATION",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97201",
            "country_code": "US",
            "telephone_number": "503-231-2641",
            "fax_number": "503-231-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POITRA",
        "first_name": "JOSHUA",
        "middle_name": "LEWIS",
        "credential": "CRM/PSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000107988",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "22-CRM-1438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500820235",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.