LA TRECA PHILLIPS (NPI# 1720323694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720323694 |
| Entity Type | Individual |
| Full Name | LA TRECA PHILLIPS |
| Practice Address |
509 Ne Alberta St Portland OR 97211-3976 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5032497767 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
509 NE ALBERTA ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97211-3976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376659987 | Debra Jean Cullen | Counselor | 509 Ne Alberta St, Portland, OR 97211-3976 | 2006-08-23 |
| 1952921736 | Lillian E Moffitt | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2020-04-21 |
| 1841690005 | Jacki Penny | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2014-08-25 |
| 1043635329 | Michael Phelps | Case Manager/Care Coordinator | 509 Ne Alberta St, Portland, OR 97211-3976 | 2014-02-24 |
| 1598180879 | Robert Nicholas | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2014-02-24 |
| 1689096489 | Allissa Andersen | Case Manager/Care Coordinator | 509 Ne Alberta St, Portland, OR 97211-3976 | 2014-01-13 |
| 1730523648 | Leandro Alberto Lopez | Case Manager/Care Coordinator | 509 Ne Alberta St, Portland, OR 97211-3976 | 2013-04-22 |
| 1013268549 | David Bowman Volker | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2012-09-24 |
| 1124377841 | Carol L Nieman | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2012-09-10 |
| 1104181866 | Lance Thomas | Adult Companion | 509 Ne Alberta St, Portland, OR 97211-3976 | 2012-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386104586 | Rachel Joy Kendall | Counselor | 5257 Nw Martin Luther King Jr. Blvd, 202e, Portland, OR 97211 | 2019-03-22 |
| 1073014601 | Kelli Minton | Behavior Technician | 7035 Ne 9th Ave, Portland, OR 97211 | 2018-02-28 |
| 1083145726 | Warren H Baumann | Registered Nurse | 854 Ne Simpson St, Portland, OR 97211 | 2017-03-24 |
| 1407277411 | Regina Barnett | Case Manager/Care Coordinator | 509 Ne Alberta St., Portland, OR 97211 | 2013-12-17 |
| 1578905964 | Carmel Therese Irving | Social Worker | 5912 Ne 16th Ave, Portland, OR 97211 | 2013-07-25 |
| 1629310990 | Lisa Peacock | Counselor | 4433 Ne 35 Place, Portland, OR 97211 | 2013-03-25 |
| 1285907915 | Michele Karen Koder | Pharmacist | 3529 Ne Martin Luther King, Jr. Blvd., Portland, OR 97211 | 2012-02-10 |
| 1629368196 | Alexis Miranda Barker | Massage Therapist | 4929 Ne 30th Ave, Zen Space Healing, Portland, OR 97211 | 2011-04-18 |
| 1396041760 | Kara Ann Fuerst | Specialist | 3325 Ne Prescott, Portland, OR 97211 | 2011-02-02 |
| 1063746337 | Laura K Elvers | Pharmacist | 6116 Ne Mlk, Portland, OR 97211 | 2009-09-18 |
| Find all providers in zip 97211 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| 1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1255789731 | Sherri Schroeder | Adult Companion | 847 Ne 19th Ave., Suite100, Portland, OR 97232 | 2016-05-25 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1609241371 | Denise Broom | Adult Companion | 25 Ne Stafford St, Portland, OR 97211-2241 | 2015-12-07 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on LA TRECA PHILLIPS.
| 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.