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AJNA RAE
NPI 1124633326
Counselor - Mental Health in Portland, OR

Active since September 14, 2020Opted out of Medicare · through Mar 1, 2028
3550 N INTERSTATE AVE, PORTLAND, OR 97227(855) 632-8280 Get Directions Write a Review

NPPES record last updated: September 14, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ajna Rae NPPES

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

AJNA RAE (NPI 1124633326) is an individual mental health provider in Portland, Oregon and active in the NPI registry since September 2020. She has opted out of Medicare through March 1, 2028.

NPPES Registry Identity

NPI1124633326
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameAJNA RAE
Location Address3550 N INTERSTATE AVEPortland, OR 97227-1196
Mailing Address4659 Ne Ainsworth StPortland, OR 97218-1849 · (503) 318-5590
Phone(855) 632-8280
Sole ProprietorYes
Enumeration DateSeptember 14, 2020
NPPES CertifiedSeptember 14, 2020
✔ NPI 1124633326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
3550 N INTERSTATE AVE, Portland, OR 97227
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ajna Rae has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 1, 2024 through March 1, 2028.

Opt-Out Effective DateMarch 1, 2024
Opt-Out In Effect ThroughMarch 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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.

JAMES PAUL BRYANT LCSW, CADC 3
Counselor
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 964-0000
ALISON D. ARMOUR PSYD
Psychologist (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 813-2000
MS. JESSICA A DUDLEY FNP
Nurse Practitioner (Family)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 746-1575
DANAYA LEE HALL SWHNP
Nurse Practitioner
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (800) 813-2000
MS. JANET LEE MUCKRIDGE RD LD
Dietitian, Registered
3550 N INTERSTATE AVE, NUTRITION DEPARTMENT EAST INTERSTATE
PORTLAND, OR 97227
Multnomah County (503) 286-6871
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Pharmacy (Managed Care Organization Pharmacy)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (866) 279-6122
COURTNEY JOHNSON LCSW
Social Worker (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (800) 813-2000
CHIA NENG VANG RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (866) 279-6122

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 Ajna Rae's NPI number?

The NPI number for Ajna Rae is 1124633326. It was assigned to this individual provider in the NPPES registry on September 14, 2020.

Where is Ajna Rae located?

Ajna Rae practices at 3550 N Interstate Ave, Portland, OR 97227. The listed phone number is (855) 632-8280.

What is Ajna Rae's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Ajna Rae enrolled in Medicare?

No. Ajna Rae has opted out of Medicare through March 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Ajna Rae was last updated on September 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.