UNIVERSITY PROFESSIONAL SERVICES (NPI# 1316354970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316354970 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PROFESSIONAL SERVICES |
| Other Organization Name | OHSU AVEL GORDLY CENTER FOR HEALING |
| Practice Address |
621 Sw Alder St Suite 520 Portland OR 97205-3626 |
| Mailing Address |
2055 Nw Savier St. Suite 201 Portland OR 97209-1773 |
| Practice Telephone | 5034944745 |
| Practice Fax Number | 5034944747 |
| Mailing Telephone | 5034948417 |
| Mailing Fax Number | 5033468021 |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |
| Authorized Official Name | MR. THOMAS M. HECKLER (SENIOR ASSOCIATE DEAN) |
| Authorized Official Telephone | 5034944481 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY PROFESSIONAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OHSU Avel Gordly Center for Healing | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073054714 | University Professional Services | Durable Medical Equipment & Medical Supplies | 9317 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-03-14 |
| 1659605707 | University Professional Services | Clinic/Center | 2858 Eberlein Ave, Klamath Falls, OR 97603-4402 | 2009-09-22 |
| 1962656868 | University Professional Services | Ophthalmology | 600 Triangle Ctr., Suite 400, Longview, WA 98632-4667 | 2008-11-05 |
| 1932724762 | University Professional Services | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-06-08 |
| 1093252553 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2017-01-23 |
| 1205385556 | University Professional Services | Internal Medicine | 2055 Nw Savier St, Suite 201, Portland, OR 97209-1770 | 2016-09-28 |
| 1750753687 | University Professional Services | Clinic/Center | 2214 Lloyd Center, Portland, OR 97232-1315 | 2015-10-30 |
| 1255722260 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2015-02-12 |
| 1912259284 | University Professional Services | General Practice | 3181 Sw Sam Jackson Park Rd, Mailcode: Ppv 350, Portland, OR 97239-3011 | 2012-10-10 |
| 1952658072 | University Professional Services | General Practice | 3303 Sw Bond Ave, Suite 9, Portland, OR 97239-4501 | 2012-08-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | UNIVERSITY PROFESSIONAL SERVICES | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 |
| Street Address |
621 SW ALDER ST SUITE 520 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97205-3626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417919325 | Kimberly Anne Humann | Psychiatry & Neurology | 621 Sw Alder St, Portland, OR 97205-3626 | 2006-04-05 |
| 1366800591 | Kristine Midyett | Social Worker | 621 Sw Alder St, Suite 400, Portland, OR 97205-3626 | 2016-02-02 |
| 1952786873 | Brandon Hardaway | Social Worker | 621 Sw Alder St, Portland, OR 97205-3626 | 2015-07-21 |
| 1114211430 | Jeniffer Duncan | Counselor | 621 Sw Alder St, Suite 520, Portland, OR 97205-3626 | 2011-06-03 |
| 1942516976 | Bounsang Khamkeo | Counselor | 621 Sw Alder St, 520 Suite, Portland, OR 97205-3626 | 2010-08-27 |
| 1437465432 | Sally Jean Vanmeter | Counselor | 621 Sw Alder St, Suite 520, Portland, OR 97205-3626 | 2010-08-27 |
| 1659692747 | Monique Mignon Jones | Psychiatry & Neurology | 621 Sw Alder St, Suite 520, Portland, OR 97205-3626 | 2010-06-13 |
| 1306178405 | Natalie Helaine Denning | Massage Therapist | 621 Sw Alder St, Portland, Portland, OR 97205-3626 | 2010-02-01 |
| 1225270408 | Alisha R. Moreland | Psychiatry & Neurology | 621 Sw Alder St, Suite #520, Portland, OR 97205-3626 | 2009-04-02 |
| 1497927396 | Jackie L Kasten | Counselor | 621 Sw Alder St, Suite 520, Portland, OR 97205-3626 | 2008-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1114374949 | Elizabeth Alire | Counselor | 1411 Sw Morrison St., Portland, OR 97205 | 2016-05-23 |
| 1508237462 | Pacific Psychology and Comprehensive Health Center | Community/Behavioral Health | 1411 Sw Morrison Ave, Suite 310, Portland, OR 97205 | 2015-10-16 |
| 1265803761 | Alana Branson | Naturopath | 1033 Sw Yamhill Street, Suite 403, Portland, OR 97205 | 2015-10-10 |
| 1720458011 | Kate Ohene | Counselor | 1411 Sw Morrison Street, Suite 310, Portland, OR 97205 | 2015-09-30 |
| 1285004671 | Christina Nannette Mendoza | Counselor | 1411 Sw Morriston Street, 310, Portland, OR 97205 | 2015-09-29 |
| 1083095947 | Patricia Burton | Registered Nurse | 1312 Sw Washinghton, Portland, OR 97205 | 2015-06-16 |
| 1649663071 | Huey Holistic | Clinic/Center | 1221 Sw Yamill, Suite 300, Portland, OR 97205 | 2015-03-10 |
| 1376952796 | Joan Kendall Ayala | Counselor | 610 Sw Alder St Ste 915, Portland, OR 97205 | 2014-08-11 |
| 1316356165 | Satheara Sin | Massage Therapist | 1033 Sw Yamhill St. #403, Portland, OR 97205 | 2014-08-06 |
| Find all providers in zip 97205 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521998 | The Practice of Jeffery Wise Therapeutics Pmhnp-bc | Clinic/Center | 2651 Nw Thurman St Apt 303, Portland, OR 97210-2327 | 2020-06-04 |
| 1356973010 | Holistic Healing Behavioral Healthcare | Clinic/Center | 5257 Ne Martin Luther King Blvd Ste 201, Portland, OR 97211-3283 | 2020-02-10 |
| 1821654112 | Hand of Mercy Health Care, LLC | Clinic/Center | 1087 Forest Ave, Portland, ME 04103-3321 | 2019-05-13 |
| 1598228579 | Christensen Counseling, LLC | Clinic/Center | 6420 Sw Macadam Avenue, Suite 390, Portland, OR 97239-9723 | 2019-04-08 |
| 1700358314 | Nikki Wetherell Counseling | Clinic/Center | 19 South St Ste 6, Portland, ME 04101-3963 | 2018-12-20 |
| 1427545961 | Value Creation Counseling | Clinic/Center | 2028 Se Marion St Apt 11, Portland, OR 97202-7365 | 2018-04-19 |
| 1982140588 | Columbiacare Services | Clinic/Center | 17720 Ne Halsey St # 1, Portland, OR 97230-6734 | 2017-01-06 |
| 1528420692 | Connections First, LLC | Clinic/Center | 2250 Nw Flanders St Ste 201, Portland, OR 97210-5410 | 2016-03-28 |
| 1194104026 | Coastal Plains Community Mhmr Center | Clinic/Center | 200 Marriott Drive, Portland, TX 78374-2213 | 2015-05-26 |
| 1841618253 | Sellwood Counseling Services | Clinic/Center | 6637 Se Milwaukie Ave, Ste. 204, Portland, OR 97202-5658 | 2014-04-02 |
| 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.