BLYTHE PATRICIA CLARK-MCKITRICK (NPI# 1609373166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609373166 |
| Entity Type | Individual |
| Full Name | BLYTHE PATRICIA CLARK-MCKITRICK |
| Practice Address |
10763 Sw Greenburg Rd Ste 100 Tigard OR 97223-5492 |
| Practice Telephone | 5039418569 |
| Practice Fax Number | 5035980934 |
| Mailing Telephone | 5039418569 |
| Mailing Fax Number | 5035980934 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
T-18-017 | OR | Behavioral Health & Social Service Providers |
| Street Address |
10763 SW GREENBURG RD STE 100 |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-5492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366846651 | Leanna Jones | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223 | 2014-10-15 |
| 1225641178 | Elizabeth Jean Hooker-foy | Licensed Practical Nurse | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-08-28 |
| 1740806579 | Sherry Beeler | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-06-17 |
| 1295364693 | Mitchell W Jones | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-04-07 |
| 1679103709 | Anna Marie Mcdaniel-martin | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-01-16 |
| 1063053429 | Ashley Legault | Licensed Practical Nurse | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2019-10-07 |
| 1619539863 | Chelsea Lee Hawes | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2019-07-08 |
| 1598320616 | Trisha Ann Whiting | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2019-05-03 |
| 1154813798 | Laura Beth Griffin | Licensed Practical Nurse | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2018-05-30 |
| 1124524962 | Karen Janine Fine | Licensed Practical Nurse | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2018-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1497284822 | Lorna Ann Gusner | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-06-08 |
| 1851848857 | Jasmine Veda Holder | Counselor | 12505 Sw North Dakota St, Tigard, OR 97223-3284 | 2016-09-07 |
| 1215329545 | Jason Ryan Grismore | Counselor | 10362 Sw Mcdonald, Tigard, OR 97224 | 2015-02-24 |
| 1366846651 | Leanna Jones | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223 | 2014-10-15 |
| 1467644971 | Patty Ann Falkenstein | Counselor | 11895 Sw Greenburg Road, Tigard, OR 97223 | 2007-08-17 |
| 1821212713 | Devon A Mathews | Counselor | 11945 Sw Pacific Hwy, #113, Tigard, OR 97223-6469 | 2007-04-12 |
| 1740806579 | Sherry Beeler | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-06-17 |
| 1275154957 | Christopher Brent Bucar | Counselor | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2020-05-04 |
| 1295364693 | Mitchell W Jones | Counselor | 10763 Sw Greenburg Rd Ste 100, Tigard, OR 97223-5492 | 2020-04-07 |
| Find all providers in TIGARD | ||||
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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.