| Lutheran Community Services Northwest | |
|
605 Se Cesar E Chavez Blvd Portland OR 97214-3216 | |
| (503) 231-7480 | |
| (503) 731-9574 |
| Full Name | Lutheran Community Services Northwest |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 Se Cesar E Chavez Blvd, Portland, Oregon |
| Authorized Official Name and Position | Peter Vogelaar (DISTRICT DIRECTOR) |
| Authorized Official Contact | 5032317480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Community Services Northwest 605 Se Cesar E Chavez Blvd Portland OR 97214-3216 Ph: (503) 231-7480 | Lutheran Community Services Northwest 605 Se Cesar E Chavez Blvd Portland OR 97214-3216 Ph: (503) 231-7480 |
| NPI Number | 1326056433 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 05/16/2025 |
| Certification Date | 05/16/2025 |
| Medicare PECOS PAC ID | 1254237522 |
|---|---|
| Medicare Enrollment ID | O20031210000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326056433 | NPI | - | NPPES |
| 111476 | Medicaid | OR | |
| 500795562 | Medicaid | OR |
| Provider Name | Garrick D Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124287594 PECOS PAC ID: 5193983591 Enrollment ID: I20120214000669 |
| Provider Name | Barbara E Gilbertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225217409 PECOS PAC ID: 8123012358 Enrollment ID: I20130425000062 |
| Provider Name | Caroline H Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538562954 PECOS PAC ID: 6507155751 Enrollment ID: I20160511002418 |
| Provider Name | Krista L Fuqua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013347582 PECOS PAC ID: 8729201462 Enrollment ID: I20161102000197 |
| Provider Name | Samantha Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386195139 PECOS PAC ID: 6608119805 Enrollment ID: I20190509001641 |
| Provider Name | Krysta M Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235520289 PECOS PAC ID: 2961857016 Enrollment ID: I20231010003808 |
| Provider Name | Kate Erin Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033887039 PECOS PAC ID: 8628424959 Enrollment ID: I20231024000096 |
| Provider Name | Cara Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427512979 PECOS PAC ID: 9931573508 Enrollment ID: I20240122002324 |
| Provider Name | Tara C Senieur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821128547 PECOS PAC ID: 2163668476 Enrollment ID: I20240719002803 |
| Provider Name | Rebecca Marie Majares Hampton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366940983 PECOS PAC ID: 7517405111 Enrollment ID: I20240814001738 |
| Provider Name | Emily Broom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063811073 PECOS PAC ID: 3375082860 Enrollment ID: I20240828002809 |
| Provider Name | Pablo Daniel Gaspar-lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508475112 PECOS PAC ID: 7416496542 Enrollment ID: I20240903002386 |
| Provider Name | Alicia Kim Trukositz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821233859 PECOS PAC ID: 1456891258 Enrollment ID: I20240907000098 |
| Provider Name | Olga Marchenkova |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518697895 PECOS PAC ID: 0345781118 Enrollment ID: I20240919002759 |
| Provider Name | Sebastian Molfa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003211350 PECOS PAC ID: 3870027105 Enrollment ID: I20241108003634 |
| Provider Name | Ludmilla Zuckman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851644231 PECOS PAC ID: 5597292250 Enrollment ID: I20241219003053 |
| Provider Name | Adrian Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841830627 PECOS PAC ID: 6800217951 Enrollment ID: I20250409000673 |
| Provider Name | Christie L Seumalo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790126027 PECOS PAC ID: 6204353485 Enrollment ID: I20250512000415 |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Cascadia Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2950 Se Stark St Ste 130, Portland, OR 97214 Phone: 971-270-0167 |