Jagger & Crew International LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

JAGGER & CREW INTERNATIONAL LLC

Doing business as

Mission Psychiatry

Practice address

1975 NW 167TH PL Ste 100-11
Beaverton, OR 97006-4908

Phone

(971) 571-5012

Fax

(971) 233-6448

NPI assigned

Jun 13, 2024

Last updated

Oct 18, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Derin ColvinNPI 1346989944

Title

Owner

Phone

(971) 571-5012

Specialties & licenses 1

Addresses

Other names 1

• Mission Psychiatry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derin Colvin

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaverton, OR
  • NPI 1346989944
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1003659590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL STE 100-11",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "971-571-5012",
            "fax_number": "971-233-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 E Warner Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852963065",
            "country_code": "US",
            "telephone_number": "602-363-4574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAGGER & CREW INTERNATIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "DERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-571-5012",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mission Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.