Individual provider Active NPI

Assefa Jima

  • Adult Mental Health Clinic/Center
  • Gresham, OR
National Provider Identifier
1205730843
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Practice address
6473 SE 31St Ter
Gresham, OR 97080-8083
Phone
(971) 407-8280
NPI assigned
Oct 6, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X OR Primary

Addresses

Primary practice location

6473 SE 31St Ter
Gresham, OR 97080-8083

Mailing address

6473 SE 31St Ter
Gresham, OR 97080-8083
Phone (971) 407-8280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1205730843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 SE 31ST TER",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970808083",
            "telephone_number": "971-407-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6473 SE 31ST TER",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970808083",
            "telephone_number": "971-407-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMA",
        "first_name": "ASSEFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.