MR. PATRICK R MARTIN (NPI# 1669090478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669090478 |
| Entity Type | Individual |
| Full Name | MR. PATRICK R MARTIN |
| Credential | MS |
| Practice Address |
12655 Sw Center St Ste 100 Beaverton OR 97005-1600 |
| Mailing Address |
5002 Foothills Rd Apt E Lake Oswego OR 97034-3169 |
| Practice Telephone | 9712246319 |
| Mailing Telephone | 5038412229 |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487284998 | Patrick Martin | Student in an Organized Health Care Education/Training Program | 4315 Golf Club Dr Apt 6006, Auburn, AL 36830-5896 | 2020-01-23 |
| 1417251489 | Patrick Thomas Martin | Pediatrics | 213 Plymouth Road, Gwynedd Valley, PA 19437 | 2011-01-05 |
| 1598908022 | Patrick Martin | Emergency Medicine | 625 Bakers Bridge Ave Ste 101, Department of Emergency Medicine, Franklin, TN 37067-1788 | 2009-04-14 |
| 1346404001 | Patrick William Martin | Family Medicine | 571 W Main St Ste 100, Lewisville, TX 75057-3667 | 2008-07-11 |
| 1700997046 | Patrick Warren Martin | Psychologist | Clement J Zablocki Vamc 5000 W National Ave, Rm 3500a, Milwaukee, WI 53295-0001 | 2006-08-31 |
| 1306821202 | Patrick David Martin | Psychiatry & Neurology | 1201 Medical Center Dr, Wilmington, NC 28401 | 2005-12-13 |
| 1972129849 | Patrick Martin | Pharmacist | 16803 Lorain Ave, Cleveland, OH 44111-5510 | 2020-06-17 |
| 1891274619 | Patrick D Martin | Counselor | 1742 Cheryl St, Clarksdale, MS 38614-7218 | 2018-08-13 |
| 1609222801 | Patrick Martin | Physical Therapy Assistant | 3515 Palm Harbor Blvd, Suite A, Palm Harbor, FL 34683-1413 | 2016-05-06 |
| 1366734675 | Patrick A Martin Jr. | Counselor | 815 S Pearl St, Tacoma, WA 98465-2117 | 2011-05-04 |
| Street Address |
12655 SW CENTER ST STE 100 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-1600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659730125 | Amanda Hermens | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2016-02-12 |
| 1336748771 | Sarah Lynn Livengood | Psychologist | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-10-17 |
| 1710585005 | Klarissa Gaskell | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-10-09 |
| 1649885245 | Mical Ventura | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-09-10 |
| 1922612837 | Hannah Elizabeth Latimer-snell | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-09-08 |
| 1801400742 | Jonathan Willden | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-09-08 |
| 1669096509 | Alina Grimsted | Student in an Organized Health Care Education/Training Program | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-06-06 |
| 1356964647 | Molly Elissa Frechette | Counselor | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-05-21 |
| 1568095339 | Shawn Kevin Hudson | Peer Specialist | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-02-19 |
| 1245874148 | Molly Kay Jarvis | Community/Behavioral Health | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2019-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420001 | Guillaume Counseling Services, P.C. | Community/Behavioral Health | 10445 Sw Canyon Rd Ste 115, Beaverton, OR 97005-1938 | 2019-01-07 |
| 1588131411 | Mind & Body Wellness of Beaverton | Community/Behavioral Health | 4545 Sw Angel Ave Apt 108, Beaverton, OR 97005-2717 | 2018-10-29 |
| 1952643835 | Center for Behavioral Invervention Inc. | Community/Behavioral Health | 4345 Sw 109th, Beaverton, OR 97005 | 2013-03-19 |
| 1912298092 | Julie A. Dicks, Ph.d., P.C. | Community/Behavioral Health | 4900 Sw Griffith Dr Ste 235, Beaverton, OR 97005-4649 | 2011-04-25 |
| 1942476189 | Cedar Counseling Center | Community/Behavioral Health | 11975 Sw 2nd St Ste 110, Beaverton, OR 97005-3042 | 2008-05-07 |
| 1053594978 | Growth Endeavor PC | Community/Behavioral Health | 6935 S.w. Hall Blvd, Beaverton, OR 97008 | 2007-12-13 |
| 1245874148 | Molly Kay Jarvis | Community/Behavioral Health | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2019-11-04 |
| 1366953267 | Inner Insight Counseling LLC | Community/Behavioral Health | 6700 Sw 105th Ave Ste 203, Beaverton, OR 97008-8824 | 2017-10-18 |
| 1215463518 | Heather Greene LLC | Community/Behavioral Health | 12555 Sw 1st St, Beaverton, OR 97005-0546 | 2017-05-04 |
| 1750831756 | Aim High | Community/Behavioral Health | 16205 Nw Bethany Ct, #100, Beaverton, OR 97006-4687 | 2016-10-13 |
| Find all providers in BEAVERTON | ||||
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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.