Active NPI
Jessica Martin, RN
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1073461612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 201141649RN
- Practice address
- 11611 NE Ainsworth Cir
Portland, OR 97220-9017 - Phone
- (503) 255-1841
- NPI assigned
- Mar 19, 2026
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 201141649RN | OR | Primary |
Addresses
Primary practice location
11611 NE Ainsworth Cir
Portland, OR 97220-9017
Mailing address
1117 NE Skidmore St
Portland, OR 97211-4665
Phone (415) 305-9398
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201141649RN | OR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1073461612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 NE SKIDMORE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972114665",
"telephone_number": "415-305-9398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11611 NE AINSWORTH CIR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972209017",
"telephone_number": "503-255-1841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JESSICA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-19",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "201141649RN",
"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 Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.