Active NPI
Myriah Sierra
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1982952362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L7937
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181016000452 | CA | Order and Referring Only - Clinical Social Worker | 4082966387 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L7937 | OR | MD | Clinical Social Worker |
| 60599 | CA | MD | General 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.