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Governance Register
US nonprofit · EIN 930706892 · Portland, ORiSource and licenceOrganisation record IRS Exempt Organizations Business Master File (EIN 930706892) - NTEE activity code, address.Board and officers IRS Form 990 annual filings, Part VII (directors, trustees, officers, key employees), read year by year to observe time served.Latest return IRS Form 990 series e-file data - 990 for the year to 30 June 2025: assets, liabilities, staff, website, telephone, pay, related organisations (Schedule R).Renewal outlook Computed by Governance Register from the observed filing history and filed revenue. Not a statement that the organisation is recruiting.Deductibility IRS Publication 78 data (code PC), downloaded 18 October 2026.Licence US Federal Government public domain.How we handle data

Fora Health Inc's network

12 people3 organisationsi12 people and 3 organisations on this map.The large node is the subject of this page. Solid lines are what the register itself records (12). Violet dotted lines (7) are likely: the same full name sits on the current board of another organisation in the same register and region. Form 990 filings give names without a person identifier; SEC insider filings carry a CIK. It may be a different person.

The board

12 listediTime on the board is observed from the annual filings: the IRS files no appointment date, so the bar counts years from the first filing the person appears on - a lower bound, not a filed start date. Names are exactly as filed. The IRS publishes no person identifier, so this edition does not yet link a person across organisations in the tables. The network map shows same-name matches as likely links only, never as confirmed.Time served and departures are observed across annual filings. Observed time served is a lower bound - a member may have joined before the first year on record. The organisation reported 12 voting members of its governing body on its latest Form 990 Part VI, which matches the board listed here.
NameRole as filedSinceOn the board
James Polo ChairChair2020
6 yrs
Amit ShahMember at Large2021
5 yrs
Andy DarkinsVice-Chair2022
4 yrs
Charles WilliamsonNurse2025
1 yr
Dr Terry JohnssonDirector2023
3 yrs
Jack LevyDirector2025
1 yr
Jason NashTreasurer2018
8 yrs
Kelsie CrippenDirector2023
3 yrs
Kevin ValkDirector2021
5 yrs
Melissa ToppCompany secretary2020
6 yrs
Susan GageDirector2025
1 yr
Thomas BialozorDirector2025
1 yr
Under 5 years5 to 6 years6 years or moreShow all 12 →

Officers and senior leadership

20 listediNamed in Part VII as officers, key employees or highest-compensated staff - not board members, shown for completeness.
NameTitle as filedOn the filings
Andrew LangeFacilities Directorsince 2022
Angel GalluzzoDirector of Finance2025
Chaney Reel DavisDirector of Medical Servicsince 2018
Charles WilliamsonNurse2024
Charlotte VancleveNurse Practitionersince 2021
Courtney WoodCFOsince 2024
Devarshi BajpaiCEOsince 2024
Eowyn RiekeMedical Directorsince 2022
Jana VarnerSenior Director of Operationssince 2024
Jennifer HartleyInterim Chief Medical Officersince 2022
Jessica GreggFormer Chief Medical Officersince 2022
Kathleen ReynoldsNurse2025
Kevin MahonChief Clinical Officersince 2020
Kevin McAdamsController (Former)since 2019
Kristen TaubNurse Practitioner2020
Lindsay MacleanDir. of Operations and Compliance2021
Maree WackerFormer CEOsince 2018
Nerissa HellerCcosince 2023
Pamela BelliFormer CFOsince 2018
Patricia CanningNurse Practitionersince 2018

Pay and hours

year to 30 June 2025iFrom Part VII of the Form 990: compensation reported for each officer, director, trustee, key employee and highest-paid staff member, and the average hours a week they report. Most board members are unpaid; a blank means nothing was reported. Pay from related organisations is shown separately.
NameTitle as filedHours a weekPay from the organisationRelated organisationsOther
Devarshi BajpaiCEO40$296k$20k
Jennifer HartleyChief Medical Officer40$247k$9k
Nerissa HellerCco40$207k$18k
Courtney WoodCFO40$202k$28k
Eowyn RiekeMedical Director40$199k$18k
Charlotte VancleveNurse40$191k$20k
Jessica GreggFormer Chief Medical Offic40$183k$11k
Angel GalluzzoDirector of Finance40$175k$11k
Jana VarnerSenior Director of Operati40$163k$22k
Kathleen ReynoldsNurse40$141k$13k
Andrew LangeFacilities Director40$125k$22k
James PoloChair1$0
Andy DarkinsVice-Chair1$0
Jason NashTreasurer1$0
Melissa ToppSecretary1$0
Amit ShahMember at Large1$0
Kelsie CrippenDirector1$0
Dr Terry JohnssonDirector1$0
Kevin ValkDirector1$0
Charles WilliamsonNurse40$0
Jack LevyDirector1$0
Thomas BialozorDirector1$0
Susan GageDirector1$0

About

Legal name
Fora Health Inc
EIN
930706892
Address
10230 Se Cherry Blossom Dr, Portland, OR, 97216-2821
State
Oregon
Mission
Fora health provides treatment, care, and advocacy for all who are affected by substance use disorder. (as filed on the Form 990)
Activity (NTEE)
F50 Mental health and crisis intervention
IRS classification
501(c)03 (tax-exempt under section 501(c)(3) where shown)
Classified purpose
Mental Health & Crisis Intervention
Size band
8 (IRS master file code)
Formed
1977
Principal officer
Devarshi Bajpai (as named on the Form 990)
IRS ruling date
1 January 1977
Status
Code 01 (unconditional exemption)
Form 990 filings on record
8, latest 2025
IRS Publication 78
PC (contributions deductible)

Most connected

Related organisations (Schedule R)

Longest observed on the filings

≥8years on the filingsJason Nash
≥6years on the filingsJames Polo
≥6years on the filingsMelissa Topp
≥5years on the filingsAmit Shah

Latest return

year to 30 June 2025iFigures from the newest Form 990 or 990-EZ in the IRS e-file releases of 2025 and 2026, for the year ending 30 June 2025. US dollars, as filed.
Total assets
$30.8m
Total liabilities
$5.3m
Net assets or fund balances
$25.4m
Contributions and grants received
$2.9m
Program service revenue
$19m
Employees
218
Volunteers
13

State registration

2 entitiesiBusiness-entity registers published by US states. These records are matched to this organisation by name and state, not by EIN, and are labelled as likely matches. Street addresses are not shown.
Fora Health, Inc. likely matchiMatched by exact name and state (and ZIP where shown). State registers do not publish EINs, so this is not a confirmed match. Source: Oregon Secretary of State, active business entities (data.oregon.gov tckn-sxa6). Licence not stated. Data last fetched 18 October 2026.
State
Oregon
Entity type
nonprofit corporation
Status
Active
Formed
18 January 1978
Registered agent
Devarshi Bajpai (city and state not held)
Fora Health likely matchiMatched by exact name and state (and ZIP where shown). State registers do not publish EINs, so this is not a confirmed match. Source: Oregon Secretary of State, active business entities (data.oregon.gov tckn-sxa6). Licence not stated. Data last fetched 18 October 2026.
State
Oregon
Status
Active
Formed
10 May 2021
Registered agent
Not stated

Authorized representatives (1)

  • Devarshi Bajpai authorized representative

City and state of officers are not held in this extract.