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ETHAN BULISCO
NPI 1073355798
Peer Specialist in Portland, OR

Active since June 12, 2024
5331 S MACADAM AVE STE 287, PORTLAND, OR 97239(503) 635-3416 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ethan Bulisco NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN BULISCO (NPI 1073355798) is an individual peer specialist in Portland, Oregon and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1073355798
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameETHAN BULISCO
Location Address5331 S MACADAM AVE STE 287Portland, OR 97239-3849
Mailing Address5331 S Macadam Ave Ste 287Portland, OR 97239-3849
Phone(503) 635-3416
Sole ProprietorNo
Enumeration DateJune 12, 2024
NPPES CertifiedJune 12, 2024
✔ NPI 1073355798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
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.
5331 S MACADAM AVE STE 287, Portland, OR 97239
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL KEIFALA SWARAY
Social Worker (Clinical)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ALEC PASCUAL LARRAZA
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
TATE BEERS
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
FRAN ZOLDYCK
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
SIERRALAND LUNA NITA GALE
Peer Specialist
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
KYLE SANTIAGO MCBRIDE
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
LILYANA JULIETTE DOUPE
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
FIRST MOON ISABELLE VENECIA
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Bulisco's NPI number?

The NPI number for Ethan Bulisco is 1073355798. It was assigned to this individual provider in the NPPES registry on June 12, 2024.

Where is Ethan Bulisco located?

Ethan Bulisco practices at 5331 S Macadam Ave Ste 287, Portland, OR 97239. The listed phone number is (503) 635-3416.

What is Ethan Bulisco's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Ethan Bulisco was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.