JOHN RAVEN
NPI 1609069921
Counselor - Addiction (Substance Use Disorder) in Portland, OR

Q: What is John Raven's NPI number?

The NPI number for John Raven is 1609069921. It was assigned to this individual provider in the NPPES registry on August 21, 2007.

Q: What is John Raven's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for John Raven was last updated on December 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 21, 2007PECOS Enrolled

2505 SE 11TH AVE STE 332, PORTLAND, OR 97202(503) 206-9696 Get Directions Write a Review

NPPES record last updated: December 23, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 23, 2021, Sep 23, 2019 (2 updates tracked since 2019).

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About John Raven NPPES

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

JOHN RAVEN (NPI 1609069921) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (10-12-70) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Clackamas.

NPPES Registry Identity

NPI1609069921

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameJOHN RAVEN

Location Address2505 SE 11TH AVE STE 332Portland, OR 97202-1063

Mailing Address10951 Se Stevens WayHappy Valley, OR 97086-7435 · (503) 206-9696

Phone(503) 206-9696

Sole ProprietorYes

Enumeration DateAugust 21, 2007

Last NPPES UpdateDecember 23, 20212 updates tracked since enumeration

NPPES CertifiedDecember 23, 2021

✔ NPI 1609069921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OR · 10-12-70

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License C3475 (OR)

2505 SE 11TH AVE STE 332, Portland, OR 97202

Open in Google Maps ↗

Secondary Practice Location 1

Location 19800 SE Sunnyside RdClackamas, OR 97015-9750 · Phone (503) 249-3434

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Raven is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show John Raven reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest

1.2 mi

General Practice

3060 SE HAWTHORNE BLVD
Portland, OR 97214

Reassigned Medicare billing, Oregon enrollment
3,207 clinicians in this Medicare group

NPI 1063990695 (800) 813-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 John Raven's NPI number?

The NPI number for John Raven is 1609069921. It was assigned to this individual provider in the NPPES registry on August 21, 2007.

Where is John Raven located?

John Raven practices at 2505 SE 11th Ave Ste 332, Portland, OR 97202. The listed phone number is (503) 206-9696.

What is John Raven's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is John Raven enrolled in Medicare?

Yes. John Raven is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Raven's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Raven reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Raven's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Raven accept?

Health plans from Kaiser Permanente and Providence Health Plan list John Raven as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Raven was last updated on December 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.