JOHN RAVEN – Addiction (Substance Use Disorder) Counselor, NPI 1609069921

JOHN RAVEN is a healthcare provider. based in Portland, Oregon. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. C3475 (OR). The NPI Number for JOHN RAVEN is 1609069921

Main info

Male
Sole Proprietor
Name
JOHN RAVEN
NPI
1609069921
Phone
(503) 206-9696
Address
2505 SE 11TH AVE STE 332
Enumeration Date
21 August 2007
Last Update Date
23 December 2021

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:18State licenses:2Other namesUpdated within 12 months

Provider Addresses for JOHN RAVEN

  • 2505 SE 11TH AVE STE 332

    PORTLAND, OR 972021063

    Phone: (503) 206-9696

    Type: Location

  • 227, Southeast 11th Avenue, Central Eastside, Buckman, Portland, Metro, Multnomah County, Oregon, 97214, United States

    PORTLAND, OR 972141316

    Phone: (503) 555-5555

    Type: Location

  • 9800 SE Sunnyside Rd

    Clackamas, OR 970159750

    Phone: (503) 249-3434

    Type: Location

  • 10951, Southeast Stevens Way, Harmony Point, Happy Valley, Metro, Clackamas County, Oregon, 97086, United States

    HAPPY VALLEY, OR 970867435

    Phone: (503) 206-9696

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240422001291IMental Health CounselorORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97202)

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Reviews

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Frequently asked questions

Where can patients find JOHN RAVEN's NPI?
You can confirm JOHN RAVEN with NPI 1609069921; it appears in the national provider directory.
Is JOHN RAVEN currently active in the NPI registry?
CMS-published data lists JOHN RAVEN as an active registrant.
Does JOHN RAVEN list a primary specialty?
If you are matching referrals, note Addiction (Substance Use Disorder) Counselor for JOHN RAVEN. Clinical services aligned with this taxonomy classification.
What location metadata exists for JOHN RAVEN?
The page summarizes Portland, Oregon for JOHN RAVEN; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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