OMAR MEDINA (NPI# 1346780103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346780103 |
| Entity Type | Individual |
| Full Name | OMAR MEDINA |
| Credential | BSW, QMHA |
| Practice Address |
6200 Se King Rd Portland OR 97222-2891 |
| Practice Telephone | 5035466377 |
| Mailing Telephone | 5035466377 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
93-0841022 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500679014 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003302662 | Omar A Medina I | Specialist/Technologist | 12411 Slauson Ave Ste H, Whittier, CA 90606-2835 | 2018-07-06 |
| 1932633591 | Omar Medina | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2017-04-20 |
| 1225365620 | Omar Medina | Counselor | 2927 N 5th St, Philadelphia, PA 19133-2800 | 2009-11-06 |
| Street Address |
6200 SE KING RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97222-2891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275695934 | Northwest Family Services | Social Worker | 6200 Se King Rd, Portland, OR 97222-2891 | 2006-12-15 |
| 1083215958 | Kennedy Cheyenne Benitez | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2020-11-05 |
| 1508498908 | Brian Bracelin | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2020-02-04 |
| 1558905562 | Chantelle Volk | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2019-11-01 |
| 1992352538 | Terence Kennedy | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2019-08-19 |
| 1619521887 | Jonathan Boisvert | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2019-07-26 |
| 1689148926 | Ravin Brown | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2019-01-21 |
| 1184119315 | Josefina Wendy Acevedo-giles | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2018-06-29 |
| 1134626831 | Liliana Acosta | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2018-04-09 |
| 1417465451 | Katelyn Cushman | Counselor | 6200 Se King Rd, Portland, OR 97222-2891 | 2018-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 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.