{
"Npi": {
"NPI": "1922498914",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHWEST COUNSELING ASSOCIATES, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4900 SW GRIFFITH DRIVE",
"SecondLineMailingAddress": "ST 157",
"MailingAddressCityName": "BEAVERTON",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97005-7107",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-869-4071",
"MailingAddressFaxNumber": "503-295-4036",
"FirstLinePracticeLocationAddress": "4900 SW GRIFFITH DRIVE",
"SecondLinePracticeLocationAddress": "ST 157",
"PracticeLocationAddressCityName": "BEAVERTON",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97005-5607",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-444-8230",
"PracticeLocationAddressFaxNumber": "503-295-4036",
"EnumerationDate": "01/28/2015",
"LastUpdateDate": "02/19/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VLIET",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "503-869-4071",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": "C2470",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}