CLIFFORD BRIAN STANGER (NPI# 1710408687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710408687 |
| Entity Type | Individual |
| Full Name | CLIFFORD BRIAN STANGER |
| Practice Address |
46314 Timine Way Pendleton OR 97801 |
| Mailing Address |
71904 Patawa Rd Pendleton OR 97801 |
| Practice Telephone | 5419669830 |
| Practice Fax Number | 5412408409 |
| Mailing Telephone | 5417011981 |
| Mailing Fax Number | 5412787568 |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2020-04-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | THW1909 | OR | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 73265 Confederated Way, Pendleton, OR 978019099 | (541) 966-9830 | 5412787568 |
| Street Address |
46314 TIMINE WAY |
| City | PENDLETON |
| State | OR |
| Zip Code | 97801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574087 | John A Eaton | Pharmacist | 46314 Timine Way, Pendleton, OR 97801 | 2005-11-07 |
| 1164029393 | Tina M Haynie | Nurse's Aide | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-10-01 |
| 1689288227 | Kolin M Craig | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-09-01 |
| 1205446663 | Vivian June Shaw | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-31 |
| 1629687876 | Rachel Marie Hoptowit | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1841809134 | Nicole Grace Whiskeyjack | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1376166876 | Andrew David Laffie | Counselor | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-05-19 |
| 1447884762 | Yellowhawk Tribal Health Center | Case Management | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-02-25 |
| 1740845973 | Robert K Bill | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2019-05-02 |
| 1568027845 | Tiffany A Legore | Dental Hygienist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2019-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720637119 | Yvonne Walker | Technician | 821 Se 9th St, Pendleton, OR 97801 | 2019-09-09 |
| 1083262703 | Praxis Medical Group Inc | Family Medicine | 2450 Sw Perkins Avenue, Pendleton, OR 97801 | 2019-08-27 |
| 1255826012 | Cosmas Chukwuemeka Nwerem Jr. | Pharmacist | 1900 Sw Court Place, Pendleton, OR 97801 | 2018-06-25 |
| 1689166811 | Helene Danielle Kuhn | Counselor | 4700 Nw Pioneer Pl, Pendleton, OR 97801 | 2018-06-04 |
| 1801302849 | Shawna L. All | Massage Therapist | 24 Se Emigrant Ave., Pendleton, OR 97801 | 2017-12-27 |
| 1033649256 | Sean Collins | Pharmacist | 203 Sw 20th St, Pendleton, OR 97801 | 2017-06-20 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1689034357 | Carre Biegel | Counselor | 17 Sw Frazer St, Ste 282, Pendleton, OR 97801 | 2016-02-24 |
| 1073995429 | Jessica Suzanne Pedersen | Massage Therapist | 812 Nw 12th St, Pendleton, OR 97801 | 2015-06-22 |
| 1861736373 | Christina Northern Northerhn | Social Worker | 331 Se 2nd Street, Pendleton, OR 97801 | 2012-11-21 |
| Find all providers in zip 97801 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124681754 | Seth Jokinen | Peer Specialist | 200 Se Hailey Ave Ste 217, Pendleton, OR 97801-3072 | 2019-04-18 |
| 1578040754 | Michelle B Kennedy | Peer Specialist | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2018-07-20 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1023625159 | Amie Loraine Martin | Peer Specialist | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2020-09-23 |
| 1689288227 | Kolin M Craig | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-09-01 |
| 1578176095 | William Daniel Bernard | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-25 |
| 1003428095 | Mariah Shaunika Ray Wright | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-20 |
| 1952913923 | Jessica Denice Pankey | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-20 |
| 1194351817 | Roxanna J Barnes | Peer Specialist | 17 Sw Frazer Ave Ste 282, Pendleton, OR 97801-0048 | 2020-03-13 |
| 1144867458 | June S Hills | Peer Specialist | 17 Sw Frazer Ave Ste 282, Pendleton, OR 97801-0048 | 2019-12-05 |
| Find all providers in PENDLETON | ||||
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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.