LIFESPAN PSYCHIATRIC CONSULTING, LLC (NPI# 1487191797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487191797 |
| Entity Type | Organization |
| Organization Name | LIFESPAN PSYCHIATRIC CONSULTING, LLC |
| Practice Address |
320 N Main Ave Suite 209 Gresham OR 97030-7242 |
| Practice Telephone | 5044915896 |
| Practice Fax Number | 8889729783 |
| Mailing Telephone | 5044915896 |
| Mailing Fax Number | 8889729783 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | MR. ANDREW VILIUS (OWNER / PRINCIPAL) |
| Authorized Official Telephone | 5034915896 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
20070075NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LIFESPAN PSYCHIATRIC CONSULTING, LLC | 955 Ne 3rd St, Gresham, OR 97030 |
| Street Address |
320 N MAIN AVE SUITE 209 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-7242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285736769 | Shirley Ann Monroe | Counselor | 320 N Main Ave, Suite 216, Gresham, OR 97030-7242 | 2006-09-04 |
| 1174970628 | Jordana Krueger-toscher | Social Worker | 320 N Main Ave, Suite 201b, Gresham, OR 97030-7242 | 2016-05-14 |
| 1487029583 | Fresh Perspectives Counseling | Clinic/Center | 320 N Main Ave, Suite 210, Gresham, OR 97030-7242 | 2015-12-01 |
| 1447503107 | Carol Nightengale, P.C. | Preferred Provider Organization | 320 N Main Ave, Suite 216, Gresham, OR 97030-7242 | 2012-10-18 |
| 1245461136 | Catherine Jones | Counselor | 320 N Main Ave, 201-c, Gresham, OR 97030-7242 | 2009-07-27 |
| 1720297625 | Nicole R Galberth | Counselor | 320 N Main Ave, Suite 201, Gresham, OR 97030-7242 | 2007-05-21 |
| 1598882821 | Gregory G. Morse | Psychologist | 320 N Main Ave, Suite 201, Gresham, OR 97030-7242 | 2007-03-23 |
| 1003969643 | Andrew E Vilius | Registered Nurse | 320 N Main Ave, Suite 209, Gresham, OR 97030-7242 | 2007-01-18 |
| 1821179938 | Carol Lynn Nightengale | Social Worker | 320 N Main Ave, Suite 216, Gresham, OR 97030-7242 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164079588 | Patrick Lohse | Nurse Practitioner | 955 Ne 3rd St, Gresham, OR 97030-7418 | 2019-08-20 |
| 1568661528 | Stacy L. Hartline | Nurse Practitioner | 912 Ne Kelly Ave, Suite 200, Gresham, OR 97030 | 2007-07-11 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1447336037 | Kerry E M Phifer | Nurse Practitioner | 1700 Nw Civic Dr, Suite 301, Gresham, OR 97030-3770 | 2006-10-27 |
| 1215587126 | Healingspaces4u | Nurse Practitioner | 2951 Nw Division St Ste 120, Gresham, OR 97030-5293 | 2019-09-13 |
| 1366812372 | Tyler Clark Chipman | Nurse Practitioner | 600 Ne 8th St Ste 300, Gresham, OR 97030-7318 | 2015-10-02 |
| 1396947065 | Susan Ruth Sagawa | Nurse Practitioner | 2150 Ne Division St, Ste 103, Gresham, OR 97030-5813 | 2007-06-04 |
| 1790806149 | Daniel Ken Kamada | Nurse Practitioner | 333 Se 223rd Ave, Ste 204, Gresham, OR 97030-7454 | 2007-04-03 |
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|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1629687892 | Robin Sue Finney | Nurse Practitioner | 1957 Thompson Rd Ste I, Coos Bay, OR 97420-2040 | 2020-07-23 |
| 1518584457 | Akhena Health & Wellness LLC | Nurse Practitioner | 8855 Sw Holly Ln Ste 129, Wilsonville, OR 97070-8793 | 2020-06-26 |
| 1447871678 | Monarch Mental Health LLC | Nurse Practitioner | 1927 Channel St, North Bend, OR 97459-1826 | 2020-04-28 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1366071607 | Med Rx Partners, P.C. | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1417583170 | Brittany Joy Monson | Nurse Practitioner | 12115 Sw 70th Ave, Tigard, OR 97223-9647 | 2020-03-13 |
| 1073147716 | Paradigm Mental Health and Wellness LLC | Nurse Practitioner | 724 S Central Ave Ste 101d, Medford, OR 97501-7808 | 2020-03-02 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 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.