Mid-Willamette Valley Transgender Support Network

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MID-WILLAMETTE VALLEY TRANSGENDER SUPPORT NETWORK

Doing business as

Mid Willamette Trans Support Network

Practice address

260 SW Madison Ave Ste 110
Corvallis, OR 97333-4728

Phone

(541) 780-3307

NPI assigned

Sep 5, 2024

Organization subpart

No

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

Authorized official

Name

Dharma Leria Mirza, MA

Title

Grant & Health Program Coordinator

Phone

(541) 780-3307

Specialties & licenses 5

Addresses

Other names 1

• Mid Willamette Trans Support Network Doing business as

Locations

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1942035126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 SW MADISON AVE STE 110",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334728",
            "telephone_number": "541-780-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SW MADISON AVE STE 110",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334728",
            "telephone_number": "541-780-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-WILLAMETTE VALLEY TRANSGENDER SUPPORT NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "DHARMA",
        "authorized_official_middle_name": "LERIA",
        "authorized_official_title_or_position": "GRANT & HEALTH PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "541-780-3307",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Willamette Trans Support Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mid Willamette Trans Support Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher I Michel, PA-C
• Emily Michele
• Michelle Hayes LCSW, LLC
• Mid-Valley Dental Associates Corvallis LLC
• Mid-Valley Healthcare, Inc. (Samaritan Recovery Clinic Corvallis)
• Katharine Middendorf, PH.D.
• Angela Mierau, LCSW
• Luke Mierau, PA-C
• Cay Michael Mierisch, MD
• Jenna Mihelich

• Community/Behavioral Health Agency in Corvallis, OR
• Providers in Corvallis, 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 Feb 24, 2025; 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.