Individual provider Active NPI

Victoria Ellen Lathos

  • Marriage & Family Therapist
  • Corvallis, OR
National Provider Identifier
1831285592
Registry record updated May 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC37678 Issued in CA
Practice address
4455 NE Highway 20
Corvallis, OR 97330-9695
Phone
(541) 758-5900
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC37678 CA Primary

Addresses

Primary practice location

4455 NE Highway 20
Corvallis, OR 97330-9695

Mailing address

3415 SE Powell Blvd
Portland, OR 97202-3371
Phone (541) 758-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231228002609 WA Practitioner - Marriage and Family Therapist 0840640124 Reassigns benefits to 1 organization
I20240110002547 OR Practitioner - Marriage and Family Therapist 0840640124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

5125 Skyline Rd S
Salem, OR 97306-9427
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC37678CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 1, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

5125 Skyline Rd S
Salem, OR 97306
Phone (503) 361-5400

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463270400000",
    "number": "1831285592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "541-758-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 NE HIGHWAY 20",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309695",
            "telephone_number": "541-758-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHOS",
        "first_name": "VICTORIA",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC37678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.