Health Matters Northwest, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3057 Issued in OR

Legal business name

HEALTH MATTERS NORTHWEST, LLC

Practice address

1312 E Burnside St
Portland, OR 97214-1424

Phone

(971) 404-5174

Fax

(360) 597-3706

NPI assigned

Jan 8, 2016

Organization subpart

No

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

Authorized official

Name

Constance Coquillette, LCSW

Title

Partner

Phone

(971) 404-5174

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851757686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4442 SE NEHALEM ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972060952",
            "telephone_number": "971-404-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141424",
            "telephone_number": "971-404-5174",
            "fax_number": "360-597-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH MATTERS NORTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COQUILLETTE",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "971-404-5174",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3057",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500681940",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.