Individual provider Active NPI

Patsy K. Gresham, LPC

  • Counselor
  • Beaverton, OR
National Provider Identifier
1962701136
Registry record updated Mar 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C2174 Issued in OR
Practice address
3800 SW Cedar Hills Blvd
BG Plaza, Suite 200F
Beaverton, OR 97005-2027
Phone
(503) 784-5017
NPI assigned
Mar 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C2174 OR Primary

Addresses

Primary practice location

3800 SW Cedar Hills Blvd
BG Plaza, Suite 200F
Beaverton, OR 97005-2027

Mailing address

3800 SW Cedar Hills Blvd Ste 200F
Beaverton, OR 97005-2035
Phone (503) 784-5017

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

LicenseStateTypeSpecialty
C2174ORMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301097600000",
    "number": "1962701136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD STE 200F",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052035",
            "telephone_number": "503-784-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD",
            "address_2": "BG PLAZA, SUITE 200F",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052027",
            "telephone_number": "503-784-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "PATSY",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2011-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C2174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2011; 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.