IRIS HAUGEN (NPI# 1487057832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487057832 |
| Entity Type | Individual |
| Full Name | IRIS HAUGEN |
| Credential | MA, CDPT |
| Practice Address |
1245 Edgewater St Nw Salem OR 97304 |
| Mailing Address |
1245 Edgewater St Nw Salem OR 97304-4049 |
| Practice Telephone | 5033787526 |
| Practice Fax Number | 5035885803 |
| Mailing Telephone | 5033787526 |
| Mailing Fax Number | 5035885803 |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-01-03 |
| 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) |
CDPT.CO.60640506 | WA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MC60653150 | WA | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
R4180 | OR | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1601 E 4th Plain Blvd, Bldg 17, Ste B222, Vancouver, WA 986681845 | 3603978484 | 3603978494 |
| Street Address |
1245 EDGEWATER ST NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609957356 | Susan Barnes | Student in an Organized Health Care Education/Training Program | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2006-10-18 |
| 1225671910 | Summer Joy Valentine | Student in an Organized Health Care Education/Training Program | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2019-10-24 |
| 1346895075 | Anne Elizabeth Wagner | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2019-08-08 |
| 1992273718 | Marc R Malone | Psychologist | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2018-11-09 |
| 1043704554 | Erin Melissa Cox | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2018-06-18 |
| 1386167732 | Julie Marie O'connor | Social Worker | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2017-07-18 |
| 1366892408 | Miranda Featherstone | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2016-06-20 |
| 1518334028 | Ryan Matthew Gunter | Physician Assistant | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-09-01 |
| 1073903977 | Gerardo Jimenez | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-01-29 |
| 1265822167 | Ivan Gutierrez | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786740 | Julie Lynn Perkins | Counselor | 26394 Highway C, Salem, MO 65560-8655 | 2020-10-02 |
| 1003426800 | Bethany Grace Lee | Counselor | 508 E Main St Ste 500, Salem, VA 24153-4325 | 2020-08-06 |
| 1225655848 | Shannon Roosma | Counselor | 2212 Mulberry St, Salem, VA 24153-6013 | 2020-06-30 |
| 1013489707 | Stephen Todd Rohrbeck | Counselor | 4060 Macleay Rd Se Ste A, Salem, OR 97317-5801 | 2018-12-19 |
| 1346718467 | Claire Jones | Counselor | 355 High St Se Ste 2, Salem, OR 97301-3613 | 2018-11-06 |
| 1851873319 | James Joseph Briggs | Counselor | 930 25th St Se, Salem, OR 97301-5045 | 2018-08-31 |
| 1487146403 | Lugenia Small | Counselor | 4 Eakin St Ste 4a, Salem, NJ 08079-1704 | 2018-06-05 |
| 1588165807 | Cassie Fort | Counselor | 4532 Poinsettia St Ne, Salem, OR 97305-9500 | 2018-02-22 |
| 1336688654 | Carilee Ball | Counselor | 838 County Road 3233, Salem, MO 65560-0473 | 2017-02-20 |
| 1174972640 | Nina Marie Perard | Counselor | 2095 Robins Ln Se, Apt 232, Salem, OR 97306-2766 | 2016-06-06 |
| Find all providers in SALEM | ||||
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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.