Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Modupe Desiree Bansile

Individual provider Counselor · NPI 1790133031

Modupe Desiree Bansile is a Counselor in Portland, Oregon. Practices as a sole proprietor and works from 4 locations. Licensed in Oregon.

Licensed in
OR
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

209 SW Fourth Ave Ste 520
Portland, OR 97204
Phone: (541) 556-9195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 — (541) 556-9195
  • 707 Ne Couch St, Portland, OR 97232-2922 — (503) 542-4603
  • 445 Port Ave, Saint Helens, OR 97051-6225 — (541) 556-9195

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence THW2156 (OR)
Counselor Taxonomy 101Y00000X

Record details

NPI number1790133031
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 26, 2016
Last updated in NPPESOctober 30, 2018
Mailing address11073 Se Main St, Milwaukie, OR 97222

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