COLUMBIACARE SERVICES


Address: 12505 Se Raymond St, Portland, OR 97236-3931
Phone: 5037608300

COLUMBIACARE SERVICES (NPI# 1386720142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386720142
Entity Type Organization
Organization Name COLUMBIACARE SERVICES
Other Organization Name WILLAMETTE ROSE
Practice Address 12505 Se Raymond St
Portland
OR 97236-3931
Mailing Address 3587 Heathrow Way
Medford
OR 97504
Practice Telephone 5037608300
Practice Fax Number 5037608308
Mailing Telephone 5418588170
Mailing Fax Number 5418588167
Enumeration Date 2006-10-27
Last Update Date 2009-05-13
Authorized Official Name MR. ROBERT C BECKETT (EXECUTIVE DIRECTOR)
Authorized Official Telephone 5418588170
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 320800000X Community Based Residential Treatment Facility, Mental Illness 801 OR Residential Treatment Facilities
Y 323P00000X Psychiatric Residential Treatment Facility 801 OR Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OR 241906 05
OR W ROSE SERVICE PMT 516052 01

Other Provider/Organization Names

Other Name Type Code
Willamette Rose Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1427553692 Columbiacare Services Clinic/Center 29415 Russell St, Gold Beach, OR 97444 2018-03-28
1255835104 Columbiacare Services Clinic/Center 850 Swing Ln, Medford, OR 97501-1790 2018-03-23
1982140588 Columbiacare Services Clinic/Center 17720 Ne Halsey St # 1, Portland, OR 97230-6734 2017-01-06
1831640192 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 8336 Highway 62, White City, OR 97530 2016-10-20
1871946640 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 29841 Hillcrest St, Gold Beach, OR 97444-8714 2016-07-18
1194173898 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 410 Maple St, Brookings, OR 97415 2016-06-03
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
1740679182 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 11380 Se Greenburg Rd #9, Tigard, OR 97223 2015-01-22

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations COLUMBIACARE SERVICES, INC 3587 Heathrow Way, Medford, OR 97504
Oregon Corporations, Companies and Business Names COLUMBIACARE SERVICES, INC. 3587 Heathrow Way, Medford, OR 97504

Office Location

Street Address 12505 SE RAYMOND ST
City PORTLAND
State OR
Zip Code 97236-3931

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922611441 Rachel Elizabeth Garen Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2020-08-25
1104462761 Julia A Demarre Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-11-19
1629612718 Colton Hemenway Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-10-31
1649829888 Dalia Isabel Solis-cortez Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-09-10
1740837087 Mary Bredenkamp Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-08-21
1700344231 Kaitlyn Nicole Trageser Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-03-04
1326512856 Brianna Morales Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2019-01-17
1013404078 Galen V Hartzell Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2018-04-16
1427556620 Hannah M Jaimes-perez Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2018-01-23
1225548266 Ryan B Thompson Counselor 12505 Se Raymond St, Portland, OR 97236-3931 2017-10-04
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336650357 Wondmimu Edao Chako Registered Nurse 3708 Se 144th Avenue, Portland, OR 97236 2017-10-17
1881142388 John Ho Pharmacist 14700 Se Division St., Portland, OR 97236 2016-09-14
1306392527 Lori-ann Lima Nurse Practitioner Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 2016-08-28
1982096202 Allan Fitzpatrick Beals-gibson Adult Companion 15602 Se Division St., Portland, OR 97236 2015-02-24
1386047132 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 3530 Se 136th Ave. #5, Portland, OR 97236 2014-10-07
1356750319 Kendra Harding Counselor 17214 Se Division Street, Portland, OR 97236 2014-08-04
1659790400 Nghia Tran Pharmacist 8438 Se 138th Dr, Portland, OR 97236 2014-04-09
1942623764 Laurel Katherine Hallock Koppelman Nurse Practitioner 12720 Se Division Street, Portland, OR 97236 2014-01-30
1982046249 Victoria D Lathrop Massage Therapist 17221 Se Divistion St S-21, Portland, OR 97236 2013-07-26
1669819694 Ariann Von Vaughn Dental Hygienist 18011 Se Pershing Ct, Portland, OR 97236 2013-05-31
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Taxonomy Information

Taxonomy Code 323P00000X
Grouping Residential Treatment Facilities
Classification Psychiatric Residential Treatment Facility

Taxonomy Definition

A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881851186 Columbiacare Services Psychiatric Residential Treatment Facility 12501 Se Raymond St, Portland, OR 97236-3931 2008-05-22
1275620411 Columbiacare Services Psychiatric Residential Treatment Facility 12511 Se Raymond St, Portland, OR 97236-3931 2006-10-09
1588132401 Chase Steven Hardt Psychiatric Residential Treatment Facility 805 Se 151st Ave, Portland, OR 97233-2916 2018-11-08
1760939508 Discovery Practice Management, Inc. Psychiatric Residential Treatment Facility 13221 Sw 68th Pkwy, Ste 440, Portland, OR 97223-8328 2016-09-09
1093186306 Ginger's House Psychiatric Residential Treatment Facility 1000 Washington Ave, Portland, ME 04103-2751 2015-10-13
1588069801 Columbiacare Services Psychiatric Residential Treatment Facility 17640 Ne Halsey St, Portland, OR 97230-6733 2014-10-29
1851592059 Trillium Family Services, Inc. Psychiatric Residential Treatment Facility 3415 Se Powell Blvd, Portland, OR 97202-3371 2007-05-29
1215138425 Trillium Family Services, Inc. Psychiatric Residential Treatment Facility 3415 Se Powell Blvd, Portland, OR 97202-3371 2007-05-29
1811198021 Trillium Family Services Psychiatric Residential Treatment Facility 3415 Se Powell Blvd, Portland, OR 97202-3371 2007-05-29
1306987128 Trillium Family Services Psychiatric Residential Treatment Facility 3550 Se Woodward St, Portland, OR 97202-1552 2007-02-12
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Competitor

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City PORTLAND
Zip Code 97236

Improve Information

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Dataset Information

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.

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