Active NPI
Jennifer T Bowman
- Audiologist
- Portland, OR
National Provider Identifier
1063579969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 023305
- Practice address
- 11390 SE 82ND Ave
Ste 801
Portland, OR 97086-7637 - Phone
- (503) 653-5004
- Fax
- (503) 794-0531
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 023305 | OR | Primary |
Addresses
Primary practice location
11390 SE 82ND Ave
Ste 801
Portland, OR 97086-7637
Mailing address
5000 Cheshire Pkwy N
Plymouth, MN 55446-4103
Phone (188) 833-3915
Other names 1
- Jennifer Patrice Tomlin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD24830 | OR | MD | Psychiatry Physician |
| 023305 | OR | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
9427 SW Barnes Rd
Portland, OR 97225
Phone (503) 203-2040
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1063579969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 CHESHIRE PKWY N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554464103",
"telephone_number": "188-833-3915",
"fax_number": "763-268-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11390 SE 82ND AVE",
"address_2": "STE 801",
"city": "PORTLAND",
"state": "OR",
"postal_code": "970867637",
"telephone_number": "503-653-5004",
"fax_number": "503-794-0531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "JENNIFER",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "023305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "TOMLIN",
"middle_name": "PATRICE",
"code": "1",
"type": "Former Name"
}
]
}
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 Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.