CHERYL RUNYAN (NPI# 1205399656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205399656 |
| Entity Type | Individual |
| Full Name | CHERYL RUNYAN |
| Practice Address |
3415 Se Powell Blvd Portland OR 97202-3371 |
| Practice Telephone | 5032349591 |
| Mailing Telephone | 5032349591 |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669694451 | Cheryl D Runyan | Nurse Practitioner | 3020 Childrens Way, San Diego, CA 92123-4223 | 2007-05-03 |
| 1619918471 | Cheryl Runyan | Social Worker | 1929 W 21st St N, Wichita, KS 67203-2106 | 2006-06-10 |
| Street Address |
3415 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-3371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568484103 | Kelley S. Fellman | Psychiatry & Neurology | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2006-07-24 |
| 1639778715 | Nathanial Bridger Caldwell | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3396 | 2020-10-20 |
| 1104425537 | Jordan Stead | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-16 |
| 1790383560 | Patricia Sullivan | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1336747104 | Kevin Xiong | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1609474378 | Gabriella Francolla | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1447858121 | Caitlynn Smith | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-10-14 |
| 1689281321 | Ava Menchu | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-27 |
| 1255948014 | Garrett Key | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-25 |
| 1578170676 | Tenzin Namdol | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143442 | Carewell LLC | Counselor | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
| 1588226765 | Melissa Lynn Hartley | Counselor | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
| 1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
| 1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
| 1134644321 | Bridgette Hennigsen | Social Worker | 3810 Se 11th Ave, Portland, OR 97202 | 2017-08-08 |
| 1558895789 | Lenore Cangeloso | Acupuncturist | 1235 Se Division Street, Suie 117, Portland, OR 97202 | 2017-04-14 |
| 1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
| 1144684663 | Catholic Charities | Case Management | 2740 Se Powell Blvd., Portland, OR 97202 | 2016-04-11 |
| 1881082097 | Zoomcare Dental, P.C. | Dentist | 3130 Se Division Street, Building 2, Portland, OR 97202 | 2014-12-23 |
| 1124424700 | Jessica Nash | Counselor | 6411 Se 17th Ave, Portland, OR 97202 | 2014-11-10 |
| Find all providers in zip 97202 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558732966 | John William Thompson | Community Based Residential Treatment Facility, Mental Illness | 5538 Ne 24th Ave, Portland, OR 97211-6206 | 2015-10-12 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1700273638 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17700 Ne Halsey St, Portland, OR 97230-6734 | 2015-04-17 |
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1821491853 | Florence Mutie | Community Based Residential Treatment Facility, Mental Illness | 5123 Sw 62nd Ave, Portland, OR 97221-1170 | 2014-10-05 |
| 1679983381 | Janus Youth Program | Community Based Residential Treatment Facility, Mental Illness | 142 Se 160th Ave Apt 24, Portland, OR 97233-3558 | 2014-05-02 |
| 1558606384 | Renew Consulting, Inc. | Community Based Residential Treatment Facility, Mental Illness | 12810 Sw 62nd Ave, Portland, OR 97219-8034 | 2012-12-05 |
| 1558686576 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2010-04-01 |
| Find all providers in PORTLAND | ||||
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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.