Individual provider Active NPI

Myriah Sierra

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1982952362
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7937 Issued in OR
Practice address
1110 SE Alder St Ste 301
Portland, OR 97214-2400
Phone
(510) 646-0807
Fax
(541) 292-5849
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 60599 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X L7937 OR Primary

Addresses

Primary practice location

1110 SE Alder St Ste 301
Portland, OR 97214-2400

Mailing address

1110 SE Alder St Ste 301
Portland, OR 97214-2400
Phone (510) 646-0807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181016000452 CA Order and Referring Only - Clinical Social Worker 4082966387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L7937ORMDClinical Social Worker
60599CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1982952362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "510-646-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "510-646-0807",
            "fax_number": "541-292-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "MYRIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60599",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.