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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: July 19, 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


The following 20 providers are registered at the same or a nearby location.

FRAN ZOLDYCK
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
DIANNA BERENICE CERVANTES
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
SAVANNAH RAE BROWN
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
RHIANNON FOWZER
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
KIMBERLY ANN LARSON
Peer Specialist
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ADAM MATTHEW JASKULA QMHA
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
HAYLEY KING
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
AMELIA MULLER
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
MRS. RACHAEL HOPE PETERS
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
SARAH PASSADORE
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ALISON CHRISTINE MITCHELL
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
JO AINE CLARKE
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
SHANEAN L JACKSON
Peer Specialist
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ASHA ZION
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
MAHLET ABADI
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ANGELA SKILES
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
ASHLYN ILENE ASCUENA-MERCIL
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416
MARIA VELADOR GONZALEZ
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
AMY ELIZABETH BURKE
Counselor (Mental Health)
5331 S MACADAM AVE STE 287
PORTLAND, OR 97239
Multnomah County (503) 635-3416

Frequently Asked Questions

What is Ethan Bulisco's NPI number?

The NPI number assigned to this healthcare provider is 1073355798, enumerated as an "individual" on June 12, 2024.

Where is the provider located?

The provider is located at 5331 S MACADAM AVE STE 287 PORTLAND, OR 97239 and the phone number is (503) 635-3416.

What is the provider's specialty?

Peer Specialist with taxonomy code 175T00000X.