Active NPI
Richard Owens
- Peer Specialist
- Portland, OR
National Provider Identifier
1861974081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 16-CRM-117
- Practice address
- 709 NW Everett St
Portland, OR 97209-3517 - Phone
- (503) 226-4060
- NPI assigned
- Sep 4, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW-1396 | OR | |
| Peer Specialist | 175T00000X | 16-CRM-117 | OR | Primary |
Addresses
Primary practice location
709 NW Everett St
Portland, OR 97209-3517
Mailing address
232 NW 6TH Avenue
Attn: Credentialing
Portland, OR 97209
Phone (503) 501-5641
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 |
|---|---|---|---|
| THW-1396 | OR | MD | Community Health Worker |
| 16-CRM-117 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1861974081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 NW 6TH AVENUE",
"address_2": "ATTN: CREDENTIALING",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97209",
"telephone_number": "503-501-5641",
"fax_number": "503-294-4321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 NW EVERETT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093517",
"telephone_number": "503-226-4060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWENS",
"first_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW-1396",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "16-CRM-117",
"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 Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.