Active NPI
Paulie Phillips
- Student in an Organized Health Care Education/Training Program
- Portland, OR
National Provider Identifier
1962012526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5415 SW Westgate Dr
Portland, OR 97221-2409 - Phone
- (503) 645-3581
- Fax
- (503) 629-8517
- NPI assigned
- Aug 7, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-65885 | AR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5415 SW Westgate Dr
Portland, OR 97221-2409
Mailing address
5415 SW Westgate Dr
Portland, OR 97221-2409
Phone (503) 645-3581
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 |
|---|---|---|---|
| RBT-18-65885 | AR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1962012526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 SW WESTGATE DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212409",
"telephone_number": "503-645-3581",
"fax_number": "503-629-8517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5415 SW WESTGATE DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212409",
"telephone_number": "503-645-3581",
"fax_number": "503-629-8517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "PAULIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-07",
"last_updated": "2025-07-21",
"certification_date": "2025-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AR",
"license": "RBT-18-65885",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Jul 21, 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.