JUSTIN LEAK (NPI# 1750571618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750571618 |
| Entity Type | Individual |
| Full Name | JUSTIN LEAK |
| Practice Address |
0615 Sw Palatine Hill Rd Msc 101 Portland OR 97219-7879 |
| Practice Telephone | 5035351181 |
| Mailing Telephone | 5035351181 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Street Address |
0615 SW PALATINE HILL RD MSC 101 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97219-7879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861580540 | Mark Lawrence Pietrok | Specialist/Technologist | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2006-10-10 |
| 1851841019 | Natalia Mccaskill | Marriage & Family Therapist | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2016-10-11 |
| 1801291745 | Tara Boatman | Specialist/Technologist | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2014-11-04 |
| 1245426493 | Elizabeth Ratcliff Austin | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-09-21 |
| 1184745929 | Julie Carol Radostitz | Internal Medicine | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-04-02 |
| 1174647390 | Ann Marie Whiting | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-03-16 |
| 1790809812 | Nancy Jane Kalvelage | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-03-16 |
| 1114073574 | Kara Powers | Psychiatry & Neurology | 0615 Sw Palatine Hill Rd, Lewis and Clark College Counselling Center, Portland, OR 97219-4959 | 2007-01-26 |
| 1942365671 | John E Hancock | Psychologist | 0615 Sw Palatine Hill Rd, Lewis and Clark College Msc 135, Portland, OR 97219-7879 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082061 | Kelsey Miller | Marriage & Family Therapist | 5515 N Williams Ave, Portland, OR 97217-2452 | 2020-07-31 |
| 1255959631 | Veronica Terese Valdez | Marriage & Family Therapist | 4445 S Barbur Blvd Ste 205, Portland, OR 97239-4047 | 2020-07-11 |
| 1649896630 | Moving Forward Staying Present LLC | Marriage & Family Therapist | 8083 Se 13th Ave Ste 3, Portland, OR 97202-6668 | 2020-06-25 |
| 1669001723 | Jennifer Melissa Moss | Marriage & Family Therapist | 12356 Ne Brazee St, Portland, OR 97230-1841 | 2020-04-02 |
| 1174153225 | Amanda Fitzpatrick | Marriage & Family Therapist | 5410 Sw Macadam Ave Ste 250, Portland, OR 97239-3807 | 2020-01-16 |
| 1679114003 | Craig Cardamone Individual and Relational Therapy Pllc | Marriage & Family Therapist | 12 Kellogg St Apt 1, Portland, ME 04101-4375 | 2019-10-07 |
| 1538716816 | Ayala Parker | Marriage & Family Therapist | 3540 Sw Boundary St, Portland, OR 97221-3817 | 2019-08-21 |
| 1720648363 | Alicia Roshelle Turgesen | Marriage & Family Therapist | 835 Se Stephens St Ste 202, Portland, OR 97214-4636 | 2019-06-17 |
| 1194281477 | Shelbee Louise Leach Macomber | Marriage & Family Therapist | 1520 Westbrook St, Portland, ME 04102-1621 | 2019-02-12 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| Find all providers in PORTLAND | ||||
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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.