RAINA WICKHAM (NPI# 1457686073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457686073 |
| Entity Type | Individual |
| Full Name | RAINA WICKHAM |
| Practice Address |
1229 Main Street, Suite 105 Philomath OR 97370 |
| Mailing Address |
24971 Bluerock Ln Corvallis OR 97333-9554 |
| Practice Telephone | 5416091305 |
| Practice Fax Number | 5417143770 |
| Mailing Telephone | 5416091305 |
| Mailing Fax Number | 5417143770 |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2016-11-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
11-12-75 | OR | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MASTERS - PSU | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500658765 | 05 |
| Street Address |
1229 MAIN STREET, SUITE 105 |
| City | PHILOMATH |
| State | OR |
| Zip Code | 97370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255850889 | Philomath Counseling, LLC | Social Worker | 1229 Main St. #105, Philomath, OR 97370 | 2017-09-14 |
| 1548634934 | Pamela Versage | Physical Therapist | 111 North 20th, Philomath, OR 97370 | 2015-11-23 |
| 1588966402 | Aimee Lynn Lesieutre | Acupuncturist | 113 S. 10th St., Philomath, OR 97370 | 2010-11-29 |
| 1720397201 | Ronnie Louise Hansen | Social Worker | 1229 Main Street, Philomath, OR 97370 | 2010-09-30 |
| 1669799029 | Rebecca Bricker | Registered Nurse | 506 S. 19th Street, Philomath, OR 97370 | 2010-04-26 |
| 1386846038 | Rebecca D Anderson | Counselor | 1215 Main Street, Philomath, OR 97370 | 2007-06-04 |
| 1447376314 | Pediatric Therapy Professionals Inc | Clinic/Center | 111 Ne 20th St, Philomath, OR 97370 | 2007-03-22 |
| 1437201357 | Phoenix Ries | Counselor | 1322 Main St., Philomath, OR 97370 | 2007-01-18 |
| 1073699930 | Gretchen Landis | Acupuncturist | 1332 Main St., Philomath, OR 97370 | 2006-10-31 |
| 1760582985 | Mid-valley Dental of Philomath | Dentist | 2811 Main St, Philomath, OR 97370 | 2006-09-25 |
| Find all providers in zip 97370 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467333 | Paula J. Bloom | Counselor | 66 Club Rd Ste No350, Eugene, OR 97401-2420 | 2020-11-06 |
| 1902406903 | Karen Elizabeth Sanchez Dean | Counselor | 1957 Lemming Ave, Eugene, OR 97401-7231 | 2020-10-28 |
| 1356941629 | Alexandra Suzanne Parker | Counselor | 1600 Valley River Dr Ste 100, Eugene, OR 97401-2141 | 2020-10-27 |
| 1972103497 | Josalyn Lawrence | Counselor | 550 S Main St Ste 105, Lebanon, OR 97355-3335 | 2020-10-26 |
| 1932708559 | Laurie Sue Urbach | Counselor | 501 Sw Western Ave, Grants Pass, OR 97526-5811 | 2020-10-23 |
| 1720687676 | Bree Burch Counseling LLC | Counselor | 19781 Baneberry Ave, Bend, OR 97702-3360 | 2020-10-21 |
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1225637671 | Lisa Sturdivant | Counselor | 17321 Sw Woodhaven Dr, Sherwood, OR 97140-8225 | 2020-10-17 |
| Find all providers with the same taxonomy | ||||
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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.