BRENDA STAGEBERG (NPI# 1386078350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386078350 |
| Entity Type | Individual |
| Full Name | BRENDA STAGEBERG |
| Practice Address |
310 Nw Flanders St Portland OR 97209-3941 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5038273949 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
201390326RN | OR | Nursing Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
310 NW FLANDERS ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-3941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962589259 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 310 Nw Flanders St, Portland, OR 97209-3941 | 2006-11-01 |
| 1881090991 | Teri Altenhofen | Adult Companion | 310 Nw Flanders St, Portland, OR 97209-3941 | 2014-11-17 |
| 1134537640 | James Kranz | Adult Companion | 310 Nw Flanders St, Portland, OR 97209-3941 | 2014-07-28 |
| 1285045666 | Tony Fernandes | Adult Companion | 310 Nw Flanders St, Portland, OR 97209-3941 | 2014-05-19 |
| 1730515677 | Kristin Griffey | Community Health Worker | 310 Nw Flanders St, Portland, OR 97209-3941 | 2013-09-24 |
| 1841625845 | Jeremy Koehler | Counselor | 310 Nw Flanders St, Portland, OR 97209-3941 | 2013-09-09 |
| 1598106304 | Hans Detter | Registered Nurse | 310 Nw Flanders St, Portland, OR 97209-3941 | 2013-07-09 |
| 1699116525 | Aaron Truby | Community Health Worker | 310 Nw Flanders St, Portland, OR 97209-3941 | 2013-07-08 |
| 1568808350 | Matthew Tyler Pardy | Adult Companion | 310 Nw Flanders St, Portland, OR 97209-3941 | 2013-05-20 |
| 1699025346 | Toeney Flowers | Social Worker | 310 Nw Flanders St, Portland, OR 97209-3941 | 2012-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932747607 | Kendall Clayton Karch | Registered Nurse | 30 Ne Mlk Jr Blvd, Portland, OR 97232-2941 | 2019-12-12 |
| 1275810665 | Esther Gabrielle Rosengarten | Registered Nurse | 1020 Sw Taylor St Ste 745, Portland, OR 97205-2505 | 2011-11-14 |
| 1679890651 | Caroline Jones Redstone | Registered Nurse | 106 Sw Woods St, Portland, OR 97201-4739 | 2010-04-29 |
| 1053643775 | Diane Vines | Registered Nurse | 3880 Se 8th Ave, Suite 110, Portland, OR 97202-3772 | 2010-02-04 |
| 1013190081 | Kristin Lois Cummings | Registered Nurse | 5329 Ne Martin Luther King Blvd, Portland, OR 97211-3237 | 2007-12-12 |
| 1184818080 | Jacob Balinky | Registered Nurse | 3716 Ne Mlk Blvd, Portland, OR 97212-1111 | 2007-09-04 |
| 1467533778 | Patricia J. Osborne | Registered Nurse | 916 Sw King Ave, Suite 206, Portland, OR 97205-1303 | 2006-10-17 |
| 1780646430 | Marianne Decain Tarraza | Registered Nurse | 165 Lancaster St, Portland, ME 04101-2406 | 2006-04-06 |
| 1477162717 | Lynda Long | Registered Nurse | 847 Ne 19th Ave Ste 100, Portland, OR 97232-2684 | 2020-07-22 |
| 1447877352 | Shannon Barnicle | Registered Nurse | 62 Elm St, Portland, ME 04101-3091 | 2020-06-26 |
| 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.