Jillian Lucille Van Staaveren, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60654 Issued in OR

Practice address

16985 NW Cornell Rd Ste 110
Beaverton, OR 97006-5639

Phone

(503) 601-9000

Fax

(503) 601-9001

NPI assigned

Jun 17, 2014

Last updated

Oct 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1174937171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840",
            "fax_number": "423-602-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16985 NW CORNELL RD STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065639",
            "telephone_number": "503-601-9000",
            "fax_number": "503-601-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN STAAVEREN",
        "first_name": "JILLIAN",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Van Dussen, OTR/L
• Hannah Therese Van Dyke
• Hailey Van Elswyk
• Abe Howard Van Hatch, MA
• Michelle Diane Van Horn
• Taryn Weslie Van Vliet
• Kyle H. Van, D.D.S.
• Thao Van, PA
• Joseph Elias Vance, D.C.
• Vancouver DG LLC

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.