KEITH CROWNER (NPI# 1336641190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336641190 |
Entity Type | Individual |
Full Name | KEITH CROWNER |
Other Name | HERU-KA ANU |
Practice Address |
8428 N Bliss St Portland OR 97203-1177 |
Practice Telephone | 4434533010 |
Mailing Telephone | 4434533010 |
Enumeration Date | 2018-03-07 |
Last Update Date | 2018-03-07 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers | ||
N | 172V00000X | Community Health Worker | Other Service Providers | ||
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
8428 N BLISS ST |
City | PORTLAND |
State | OR |
Zip Code | 97203-1177 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578029559 | Frances Lewis | Peer Specialist | 8428 N Bliss St, Portland, OR 97203-1177 | 2019-02-14 |
1336641182 | Ankh Holistic Life Center | Peer Specialist | 8428 N Bliss St, Portland, OR 97203-1177 | 2018-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952923757 | Justin Cummings | Meals | 10105 N. Oswego Ave, Portland, OR 97203 | 2020-05-14 |
1407335045 | Gage Solis | Student in an Organized Health Care Education/Training Program | 8425 N. Lombard St, Portland, OR 97203 | 2018-08-13 |
1497103493 | Ruby Diane Ciarlante | Community Health Worker | 7803 N Portsmouth Ave, Portland, OR 97203 | 2016-05-31 |
1992139620 | Hannah Clare | Speech-Language Pathologist | 7126 N Amherst St, Portland, OR 97203 | 2013-08-29 |
1043656713 | Heather Ranae Mcintosh | Social Worker | 7323 N Burlington Ave, Portland, OR 97203 | 2013-05-21 |
1275879363 | Matthew Scott Bennett | Pharmacist | 6850 N. Lombard, Portland, OR 97203 | 2012-12-18 |
1144594094 | Candice Juliet Thomas | Pharmacist | 9000 N. Lombard St, Portland, OR 97203 | 2012-02-23 |
1093013211 | Aarisa Elysianne Smith | Mechanotherapist | 8438 N Lombard St, Ste 7, Portland, OR 97203 | 2011-03-11 |
1700103546 | Lisa Catherine Davis | Acupuncturist | 1614 Ne Alberta Street, Portland, OR 97203 | 2010-05-03 |
1427298579 | Donald Marvin Lorenzen | Denturist | 8530 N. Ivanhoe, Portland, OR 97203 | 2009-03-03 |
Find all providers in zip 97203 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
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.