SEAN NELSON (NPI# 1700350402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700350402 |
| Entity Type | Individual |
| Full Name | SEAN NELSON |
| Practice Address |
1122 Ne 122nd Ave Ste 102 Portland OR 97230-2081 |
| Mailing Address |
11006 Se Henderson Dr Portland OR 97266-5063 |
| Practice Telephone | 3107508960 |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
T-18-469 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013450188 | Sean Craig Nelson Jr. | Specialist/Technologist | 1026 E Fort Ave, Baltimore, MD 21230-5101 | 2016-11-22 |
| 1477805695 | Sean Nelson | Specialist/Technologist | 531 Lakeland Plz, Cumming, GA 30040 | 2012-10-11 |
| 1215925151 | Sean K. Nelson | Dentist | 205 6th Pl Nw, Austin, MN 55912-3025 | 2005-10-13 |
| 1669016101 | Sean Michael Nelson | Behavior Technician | 3335 M St, Merced, CA 95348-2714 | 2019-10-28 |
| 1336628882 | Sean P Nelson | Licensed Vocational Nurse | 1501 E El Paso St, Fort Worth, TX 76102-6700 | 2018-08-07 |
| 1134614902 | Sean Elliott Nelson | Counselor | 7 Vauxhall St, New London, CT 06320-5711 | 2018-06-25 |
| 1477044758 | Sean Darrell Nelson | Family Medicine | 2501 Pierce St, Sioux City, IA 51104-3725 | 2018-05-23 |
| 1083069983 | Sean Nelson | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-04-28 |
| 1437425915 | Sean Trevar Nelson | Family Medicine | 655 7th St Bldg 700700a, 78 Mdg/sgof, Robins Afb, GA 31098-2227 | 2012-03-28 |
| 1093927709 | Sean Nelson | Emergency Medicine | 720 N Denton Tap Rd, Coppell, TX 75019-2162 | 2007-05-04 |
| Street Address |
1122 NE 122ND AVE STE 102 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on SEAN NELSON.
| 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.