TARA HOLLY RAYBURN (NPI# 1134584527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134584527 |
Entity Type | Individual |
Full Name | TARA HOLLY RAYBURN |
Credential | CADCI |
Practice Address |
486 12th St Astoria OR 97103-4122 |
Practice Telephone | 5033252067 |
Practice Fax Number | 5033252153 |
Mailing Telephone | 5033252067 |
Mailing Fax Number | 5033252153 |
Enumeration Date | 2015-12-29 |
Last Update Date | 2015-12-29 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
15-11-08 | OR | Behavioral Health & Social Service Providers |
Street Address |
486 12TH ST |
City | ASTORIA |
State | OR |
Zip Code | 97103-4122 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114947942 | Columbia Lutheran Charities | Home Health | 486 12th St, Astoria, OR 97103-4122 | 2006-07-21 |
1215535687 | Amy Josephine Gauthier | Case Manager/Care Coordinator | 486 12th St, Astoria, OR 97103-4122 | 2020-10-16 |
1023038858 | Columbia Lutheran Charities | Hospice Care, Community Based | 486 12th St, Astoria, OR 97103-4122 | 2006-07-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730552845 | Kpg Oregon, LLC | Internal Medicine | 486 12th Street #200, Astoria, OR 97103 | 2015-11-11 |
1205239043 | Brittany Dawn Vigoren | Dental Hygienist | 433 30th St., Astoria, OR 97103 | 2014-10-08 |
1497188858 | Jennifer U Boggs | Counselor | 10 Pier 1 Ste 203, Astoria, OR 97103 | 2013-08-20 |
1780022046 | Judy J Curnow | Massage Therapist | 1 12th Street Suite 10, Astoria, OR 97103 | 2013-06-10 |
1659626612 | Megan Lampson | Physical Therapist | 646 16th Ave., Astoria, OR 97103 | 2012-07-16 |
1043580947 | Matthew Thomas Cassity | Physical Therapy Assistant | 646 16th St., Astoria, OR 97103 | 2012-01-09 |
1881975969 | Rebecca Nicole Roe | Contractor | 25 Whitebush Way, Astoria, OR 97103 | 2011-09-02 |
1346542214 | Michele Lynn Hart | Social Worker | 2120 Exchange, Astoria, OR 97103 | 2010-11-29 |
1447551197 | Barbara Ellen Arnold | Pharmacist | 3250 Leif Erickson Dr, Astoria, OR 97103 | 2010-11-11 |
1083915219 | Christina Louise Jones | Pharmacist | 3250 Lief Erickson Dr, Astoria, OR 97103 | 2010-11-04 |
Find all providers in zip 97103 |
Taxonomy Code | 103TA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811338056 | Anthony Nello Giardina | Psychologist | 2138 Ne Halsey St, Apt 4, Portland, OR 97232-1562 | 2013-07-16 |
1295989440 | Kristen Wilson | Psychologist | 1985 Saginaw St S, Salem, OR 97302-5235 | 2008-11-13 |
1437521788 | Recovery Partners, P.C. | Psychologist | 1500 Nw Bethany Blvd, Suite 240, Beaverton, OR 97006-5208 | 2015-10-27 |
1164891180 | Recovery Partners, P.C. At Springbrook | Psychologist | 1901 Esther St, Newberg, OR 97132-9529 | 2015-09-21 |
1013282482 | Trina Schlichting | Psychologist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2012-03-17 |
1679851075 | Terrence K Wager | Psychologist | 1800 Blankenship Rd, Ste.200, West Linn, OR 97068-4172 | 2011-08-02 |
1679861637 | Bobby L Trihub | Psychologist | 1901 Esther St, Newberg, OR 97132-9529 | 2011-07-12 |
1508033994 | Northwest Integrative Health Center PC | Psychologist | 201 N Meridian St Ste B, Newberg, OR 97132-2752 | 2008-05-14 |
1548454465 | George A Howard | Psychologist | 5 Centerpointe Dr Ste 400, Lake Oswego, OR 97035-8661 | 2007-09-04 |
1326136110 | Byron N Fujita | Psychologist | 524 Main St, Oregon City, OR 97045-1824 | 2006-10-10 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.