Allison Rae Supnick, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

14025 SW Farmington Rd
Suite 160
Beaverton, OR 97005-2512

Phone

(503) 258-4511

NPI assigned

Nov 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Allison Rae Dale Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1992049258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14025 SW FARMINGTON RD",
            "address_2": "SUITE 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052512",
            "telephone_number": "503-807-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14025 SW FARMINGTON RD",
            "address_2": "SUITE 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052512",
            "telephone_number": "503-258-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPNICK",
        "first_name": "ALLISON",
        "middle_name": "RAE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "DALE",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.