PETER ANTHONY COLISTRO (NPI# 1790138741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790138741 |
| Entity Type | Individual |
| Full Name | PETER ANTHONY COLISTRO |
| Practice Address |
1508 Sw 13th Ave Portland OR 97201-3312 |
| Mailing Address |
8915 Sw Center St Tigard OR 97223-6307 |
| Practice Telephone | 5037263832 |
| Mailing Telephone | 5037263690 |
| Mailing Fax Number | 5037263691 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1508 SW 13TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97201-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437442480 | Kari Stevens | Community/Behavioral Health | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2011-05-24 |
| 1548820087 | Tisien Wawani Palacio | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2019-06-17 |
| 1144674268 | Aisha Banse | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2016-04-14 |
| 1457728818 | Catlin Marie Moser | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2015-09-01 |
| 1932596079 | Jean Amour Phare | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2015-04-15 |
| 1154670875 | Hope C Oconnor | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2012-09-10 |
| 1730474966 | Holly Johnson | Social Worker | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2011-06-15 |
| 1083909386 | Holland Andrews | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2011-06-14 |
| 1275828675 | John Robert Mcphail | Counselor | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2011-06-14 |
| 1083909436 | Austin Jarrett Edwards | Social Worker | 1508 Sw 13th Ave, Portland, OR 97201-3312 | 2011-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206060 | Laura Elizabeth Jackson | Student in an Organized Health Care Education/Training Program | 2730 S Moody Ave, Portland, OR 97201 | 2020-05-10 |
| 1225659063 | Amanpreet Kaur | Student in an Organized Health Care Education/Training Program | Ohsu Physician Assistant Program, 2730 South Moody Ave. Mail Code: Cl5pa, Portland, OR 97201 | 2020-05-04 |
| 1063033801 | Aaron Kinn | Student in an Organized Health Care Education/Training Program | Ohsu Division of Physician Assistant Education - Cl5pa, 2730 Sw Moody Avenue, Portland, OR 97201 | 2020-05-04 |
| 1487275442 | Erin Aleen Ostlie-madden | Student in an Organized Health Care Education/Training Program | 2730 South Moody Ave, Portland, OR 97201 | 2020-04-30 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1780172619 | Susan Elizabeth Christian Barrios | Social Worker | 1505 Sw College St, Portland, OR 97201 | 2018-04-26 |
| 1730696576 | Fiona Everett | Counselor | 1703 Sw Clay St, Portland, OR 97201 | 2018-01-02 |
| 1437678844 | Akira Thomas Neilsen | Student in an Organized Health Care Education/Training Program | 1930 Sw River Drive, Unit 102, Portland, OR 97201 | 2017-09-18 |
| 1285171736 | Howard Mitchell | Technician, Other | 1110 Sw Clay Street Apt. 34, Portland, OR 97201 | 2017-01-23 |
| Find all providers in zip 97201 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1891302238 | Nina Landey | Counselor | 120 Se 53rd Ave, Portland, OR 97215-1204 | 2020-09-29 |
| 1902412166 | Peter H Addy LLC | Counselor | 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 | 2020-09-22 |
| 1326654765 | Naomi Painter | Counselor | 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 | 2020-09-21 |
| 1750996104 | Sara Fuller | Counselor | 3016 Ne 70th Ave, Portland, OR 97213-5802 | 2020-09-12 |
| 1114532983 | Matthew W Cronin | Counselor | 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 | 2020-09-09 |
| 1447865381 | Luke Colbourn | Counselor | 2705 E Burnside St Ste 206, Portland, OR 97214-1768 | 2020-09-08 |
| 1710599774 | Abigail Kathryn Ernst | Counselor | 1020 Sw Taylor St # 100, Portland, OR 97205-2543 | 2020-08-20 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on PETER ANTHONY COLISTRO.
| 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.