Active NPI
Aaron John Larson, CADC1
- Community/Behavioral Health Agency
- Portland, OR
National Provider Identifier
1982063806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 15-12-23U
- Practice address
- 1631 SW Columbia St
Portland, OR 97201-6025 - Phone
- (503) 231-2641
- NPI assigned
- Feb 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 15-12-23U | OR | Primary |
Addresses
Primary practice location
1631 SW Columbia St
Portland, OR 97201-6025
Mailing address
900 NE 149TH St
Vancouver, WA 98685-1326
Phone (360) 989-4425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15-12-23U | Other | OR | CADC1 |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1982063806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 NE 149TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986851326",
"telephone_number": "360-989-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 SW COLUMBIA ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972016025",
"telephone_number": "503-231-2641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "AARON",
"middle_name": "JOHN",
"credential": "CADC1",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-19",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "OR",
"license": "15-12-23U",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CADC1",
"identifier": "15-12-23U",
"state": "OR"
}
],
"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 Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.