POSITIVE DEVELOPMENT FOR YOUTH AND FAMILIES, INC. (NPI# 1912530643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912530643 |
| Entity Type | Organization |
| Organization Name | POSITIVE DEVELOPMENT FOR YOUTH AND FAMILIES, INC. |
| Other Organization Name | POSITIVE DEVELOPMENT FOR YOUTH AND FAMILIES |
| Practice Address |
4531 Se Belmont St Ste 110 Portland OR 97215-1675 |
| Mailing Address |
7616 N Leonard St Portland OR 97203-3231 |
| Practice Telephone | 5033335213 |
| Practice Fax Number | 8447743515 |
| Mailing Telephone | 5033335213 |
| Mailing Fax Number | 8447743515 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | DR. JUSTIN WILLIAM BUSH (CO-OWNER/LICENSED PSYCHLOGIST) |
| Authorized Official Telephone | 5033335213 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Positive Development For Youth and Families | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | POSITIVE DEVELOPMENT FOR YOUTH AND FAMILIES, INC | 7616 N Leonard St, Portland, OR 97203 |
| Street Address |
4531 SE BELMONT ST STE 110 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-1675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902440704 | Alicia Hoffman | Psychologist | 1577 Congress St Ste 2, Portland, ME 04102-2169 | 2019-11-05 |
| 1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
| 1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
| 1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
| 1215081716 | Holly Linn Crossen | Psychologist | 1130 Sw Morrison St Ste 618, Portland, OR 97205-2217 | 2007-01-22 |
| 1972654697 | Nicholas John Ure | Psychologist | 101 Se 12th Ave, Portland, OR 97214-1319 | 2007-01-16 |
| 1528134772 | Marianne Michelle Kabour | Psychologist | 2801 N Gantenbein Ave Fl 3, Portland, OR 97227-1623 | 2006-11-28 |
| 1578588539 | Shirley May Hanson | Psychologist | 7912 Sw 35th Ave, Suite 6, Portland, OR 97219-2427 | 2006-07-12 |
| 1518904457 | Redmond Andrew Reams | Psychologist | 2106 Ne 40th Ave, Portland, OR 97212-5405 | 2006-05-31 |
| 1285259952 | Alexandra Pachter | Psychologist | 1411 Sw Morrison St Ste 310, Portland, OR 97205-1945 | 2020-06-09 |
| 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.