REBEKKA KRUSE (NPI# 1760004949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760004949 |
| Entity Type | Individual |
| Full Name | REBEKKA KRUSE |
| Practice Address |
30 Ne Mlk Blvd Portland OR 97232-2941 |
| Mailing Address |
11615 Se Taylor St Portland OR 97216-3829 |
| Practice Telephone | 5032321099 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OR | Other Service Providers |
| Street Address |
30 NE MLK BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982016382 | Andrew M Given | Registered Nurse | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2014-05-20 |
| 1568086189 | Tammy Lou Bell | Peer Specialist | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2020-05-29 |
| 1639792229 | Megan Robinson | Specialist | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2020-05-19 |
| 1013530609 | Tyler William Hernandez Kadell | Case Manager/Care Coordinator | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2020-05-18 |
| 1952923047 | Janelle Eileen Bello | Peer Specialist | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2020-05-12 |
| 1639791817 | Michael James De Hart | Peer Specialist | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2020-05-11 |
| 1316503485 | Melissa L Thomas | Art Therapist | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2019-05-14 |
| 1285129627 | Rachel Leigh Marie Johnson | Registered Nurse | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2018-06-28 |
| 1912406448 | Miho Lucille Walker | Registered Nurse | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2018-02-10 |
| 1417485962 | Jennifer Sue Hickman | Registered Nurse | 30 Ne Mlk Blvd, Portland, OR 97232-2941 | 2017-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| 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 |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| 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.