Active NPI
Jon Edward Mankowski, MSW, DCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1053594564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS14417
- Practice address
- 2614 NE 44TH Ave
Portland, OR 97213-1221 - Phone
- (503) 706-7024
- NPI assigned
- Dec 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS14417 | CA | Primary |
Addresses
Primary practice location
2614 NE 44TH Ave
Portland, OR 97213-1221
Mailing address
2614 NE 44TH Ave
Portland, OR 97213-1221
Phone (503) 706-7024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS14417 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275868800000",
"number": "1053594564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2614 NE 44TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131221",
"telephone_number": "503-706-7024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2614 NE 44TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131221",
"telephone_number": "503-706-7024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANKOWSKI",
"first_name": "JON",
"middle_name": "EDWARD",
"name_prefix": "Prof.",
"credential": "MSW, DCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-07",
"last_updated": "2010-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS14417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.