AUSTYN LARSON (NPI# 1952940595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952940595 |
| Entity Type | Individual |
| Full Name | AUSTYN LARSON |
| Other Name | ROSE CROW |
| Practice Address |
4488 Ne Devils Lake Blvd Lincoln City OR 97367-5065 |
| Mailing Address |
238 3rd Ave Se Albany OR 97321-2857 |
| Practice Telephone | 5417913411 |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
4488 NE DEVILS LAKE BLVD |
| City | LINCOLN CITY |
| State | OR |
| Zip Code | 97367-5065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566759 | Mari Ruth Angeline Schuman | Peer Specialist | 4488 Ne Devils Lake Blvd, Lincoln City, OR 97367-5065 | 2019-12-30 |
| 1912546599 | Sharon Lynn Padilla | Peer Specialist | 4488 Ne Devils Lake Blvd, Lincoln City, OR 97367-5065 | 2019-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881256121 | Amanda Suzanne Cherryholmes | Peer Specialist | 1206 Se 48th Place, Montgomery, Lincoln City, OR 97367 | 2019-07-08 |
| 1982198719 | Lakeside Family Dentistry | Dentist | 3173 Ne West Devils Lake Rd., Lincoln City, OR 97367 | 2018-06-15 |
| 1891282117 | Mark J Lee | Marriage & Family Therapist | 412 Southwest Highway 101, Lincoln City, OR 97367 | 2018-04-23 |
| 1508130196 | Michelle Marie Becker | Pharmacist | 1030 Se Oar Ave Bi-mart, Lincoln City, OR 97367 | 2012-02-29 |
| 1457651465 | Laurene Norelle Alcocer | Pharmacist | 4048 Ne Hwy 101, Lincoln City, OR 97367 | 2010-10-25 |
| 1518106228 | Estate of Kevin L. Chancellor | Dentist | 3173 Ne West Devils Lake Rd, Lincoln City, OR 97367 | 2009-02-19 |
| 1346403656 | Lincoln City Pharmacy & Gifts | Pharmacy | 1800 Se Hwy 101, Suite C, Lincoln City, OR 97367 | 2008-07-07 |
| 1841487139 | Assisted Living Concepts Inc | Assisted Living Facility | 1400 Se 19th, Lincoln City, OR 97367 | 2007-10-01 |
| 1376741074 | Frank Wesley Nettleship | Dentist | 9101 Keys Place, Lincoln City, OR 97367 | 2007-07-05 |
| 1306043989 | Julie Anne Bass | Case Manager/Care Coordinator | 4402 Devils Lake Blvd #2, Lincoln City, OR 97367 | 2007-06-28 |
| Find all providers in zip 97367 | ||||
| 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 |
|---|---|---|---|---|
| 1114566759 | Mari Ruth Angeline Schuman | Peer Specialist | 4488 Ne Devils Lake Blvd, Lincoln City, OR 97367-5065 | 2019-12-30 |
| 1881256121 | Amanda Suzanne Cherryholmes | Peer Specialist | 1206 Se 48th Place, Montgomery, Lincoln City, OR 97367 | 2019-07-08 |
| 1912546599 | Sharon Lynn Padilla | Peer Specialist | 4488 Ne Devils Lake Blvd, Lincoln City, OR 97367-5065 | 2019-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
| 1962000554 | Dawn Marks | Peer Specialist | 21440 Se Stark St, Gresham, OR 97030-2024 | 2020-10-15 |
| 1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1982237236 | Jessica M Montoya | Peer Specialist | 235 Se Knowledge St, Prineville, OR 97754-2362 | 2020-02-14 |
| 1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
| 1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
| City | LINCOLN CITY |
| Zip Code | 97367 |
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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.