Jacquelyn Boliba Soule

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

13317 SE Powell Blvd
Portland, OR 97236-3335

Phone

(503) 760-9696

NPI assigned

Sep 1, 2020

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

Other names 1

• Jacquelyn Boliba Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cascadia Health

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1568531952
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1245844935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13317 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363335",
            "telephone_number": "503-760-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIBA SOULE",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "BOLIBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott C Bolen, Q.M.H.A.
• Willow Mae Bolen, WILLOW BOLEN
• Lindsay Ann Bolerjack
• Bettina Boles
• Matthew S.a. Boles, MD
• Amanda Bolich
• Erin S Bolken, PAC
• Joshua William Bolle
• Marie Boller, MD
• Tasha Marie Bollermann, D.M.D.

• Personal Care Attendant in Portland, OR
• Providers in Portland, OR by specialty
• Personal Care Attendant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.