Individual provider Active NPI

Hannah Marie Thiesen, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1932914280
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10041119 Issued in OR
Practice address
4401 SE Crystal Springs Blvd
Portland, OR 97206-0939
Phone
(952) 240-2496
NPI assigned
Feb 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10041119 OR Primary
Registered Nurse 163W00000X 201243265RN OR

Addresses

Primary practice location

4401 SE Crystal Springs Blvd
Portland, OR 97206-0939

Mailing address

4401 SE Crystal Springs Blvd
Portland, OR 97206-0939
Phone (952) 240-2496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250423002083 OR Practitioner - Nurse Practitioner 9931624806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

870 SE 82 Dr
Gladstone, OR 97027
Phone (503) 659-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201243265RNORMDRegistered Nurse
10041119ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC CurrentSince Mar 3, 2025 Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Mar 3, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

870 82nd Dr
Gladstone, OR 97027
Phone (503) 272-8031

10151 SE Sunnyside Rd
Ste 480
Happy Valley, OR 97015
Phone (503) 739-8321

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.hannahthiesen@148835.advancedmd-direct.com

Organizations & group practices 2

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": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1932914280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 SE CRYSTAL SPRINGS BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972060939",
            "telephone_number": "952-240-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 SE CRYSTAL SPRINGS BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972060939",
            "telephone_number": "952-240-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESEN",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10041119",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201243265RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.