We Rise, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

L4517 Issued in OR

Legal business name

WE RISE, LLC

Practice address

3311 NE MLK Jr Blvd
104
Portland, OR 97212-2086

Phone

(503) 317-4240

NPI assigned

Aug 13, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Juanita Rene Tucker, LCSWNPI 1114092145

Title

Ceo

Phone

(503) 317-4240

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juanita Tucker, QMHP

  • Mental Health Counselor
  • Portland, OR
  • NPI 1114092145
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471046400000",
    "number": "1922552363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 NE RODNEY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113428",
            "telephone_number": "503-317-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 NE MLK JR BLVD",
            "address_2": "104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122086",
            "telephone_number": "503-317-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WE RISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-13",
        "last_updated": "2016-08-13",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-317-4240",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "L4517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500664189",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Wayson, M.D.
• Kim A Wayson, MD
• Waystone Therapy LLC
• Paige T Wayton
• Waywest Massage
• Lori Linn Weagant-Ray, RN
• Kristen Weakland
• Kendra Weakley, RD, LD
• Johanna Wearsch
• Jasmyn Weatherhead

• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.