Jeremy Mikolai ND Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

JEREMY MIKOLAI ND INC

Practice address

2540 NE M L King Blvd
Portland, OR 97212-3732

Phone

(507) 800-0056

Fax

(844) 965-9136

NPI assigned

Feb 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Michael Mikolai, NDNPI 1811207277

Title

Medical Director/Ceo

Phone

(507) 327-4451

Specialties & licenses 1

Addresses

Other names 1

• Sequoia Natural Medicine 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.

• Jeremy Michael Mikolai, N.D.

  • Naturopath
  • New London, CT
  • NPI 1811207277
  NPD Authorized official

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1033674841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 SE HAWTHORNE BLVD # 132",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145246",
            "telephone_number": "507-800-0056",
            "fax_number": "844-965-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 NE M L KING BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123732",
            "telephone_number": "507-800-0056",
            "fax_number": "844-965-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY MIKOLAI ND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "MIKOLAI",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "507-327-4451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sequoia Natural Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William J Jenson, CRM
• Hermina Kung Jeon, MD
• Jane Jeon
• Yeong-Keun Jeong
• In Su Jeoung
• Kenneth Jerin
• Amanda Jerkins, PT
• Emily Jernigan, AUD
• Jerusha Ann Jerome, RN
• Maggie Jerome

• Primary Care Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.