Active NPI
Jessica Nason
- Physical Therapist
- Portland, OR
National Provider Identifier
1073095303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62956
- Practice address
- 707 SW Gaines St
Portland, OR 97239-2901 - Phone
- (860) 917-2128
- NPI assigned
- Sep 4, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040.0134018 | VT | |
| Physical Therapist | 225100000X | 62956 | OR | Primary |
Addresses
Primary practice location
707 SW Gaines St
Portland, OR 97239-2901
Mailing address
7338 SW 29TH Ave
Portland, OR 97219-2410
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62956 | Other | OR | OREGON PHYSICAL THERAPIST LICENSE |
| 040.0134018 | Other | VT | VERMONT PHYSICAL THERAPIST LICENSE |
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 |
|---|---|---|---|
| 62956 | OR | MD | Physical Therapist |
| 040.0134018 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1073095303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7338 SW 29TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "860-917-2128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASON",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040.0134018",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON PHYSICAL THERAPIST LICENSE",
"identifier": "62956",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VERMONT PHYSICAL THERAPIST LICENSE",
"identifier": "040.0134018",
"state": "VT"
}
],
"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 Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.