Active NPI
Sere Rachel Santa Ana, MFT
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1851099394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- R8173
- Practice address
- 11740 SW 68TH Pkwy Ste 200
Portland, OR 97223-9058 - Phone
- (971) 266-1969
- NPI assigned
- Feb 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | R8173 | OR | Primary |
Addresses
Primary practice location
11740 SW 68TH Pkwy Ste 200
Portland, OR 97223-9058
Mailing address
2355 State St Ste 101
Salem, OR 97301-4541
Phone (971) 266-1969
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
| License | State | Type | Specialty |
|---|---|---|---|
| R8173 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1851099394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2355 STATE ST STE 101",
"city": "SALEM",
"state": "OR",
"postal_code": "973014541",
"telephone_number": "971-266-1969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11740 SW 68TH PKWY STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972239058",
"telephone_number": "971-266-1969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTA ANA",
"first_name": "SERE",
"middle_name": "RACHEL",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-22",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "R8173",
"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 Feb 22, 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.