Maria E. Wunderbro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6254 Issued in OR

Practice address

8196 SW Hall Blvd
Suite 202
Beaverton, OR 97008-6409

Phone

(503) 567-1820

NPI assigned

Aug 30, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maria E. Kimbro Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Spectrums Family Services, LLC

  • Clinical Social Worker
  • Beaverton, OR
  • NPI 1508230707
  NPD (past)

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1962718700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153125",
            "telephone_number": "971-227-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8196 SW HALL BLVD",
            "address_2": "SUITE 202",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086409",
            "telephone_number": "503-567-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERBRO",
        "first_name": "MARIA",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "KIMBRO",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Worley, EDS
• James Zachary Wright, D.O.
• Teresa Faye Wright, DOT
• Wu Wei Wellness LLC
• Ling-an Wu, M.D.
• Dahlia Wyner
• Wynn Street LLC
• Rebecca Wynn, OTD
• Chenyong Xiang, PT
• Francisca Yac Riscajche

• Clinical Social Worker in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.