Jhaizmine Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11688 Issued in OR

Practice address

333 NE Russell St
Portland, OR 97212-3762

Phone

(503) 334-9955

Fax

(833) 351-2566

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1255934287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 NE 122ND AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301359",
            "telephone_number": "503-334-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NE RUSSELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123762",
            "telephone_number": "503-334-9955",
            "fax_number": "833-351-2566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2642 SW 18th Pl",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970805775",
            "country_code": "US",
            "telephone_number": "503-345-5531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4110 NE 122nd Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972301359",
            "country_code": "US",
            "telephone_number": "503-345-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JHAIZMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "A10288",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A10288",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Spencer Smith, MD
• Jessica Smith, MS
• Jessica Smith
• Jessica Smith, DO
• Jessica Anjuli Smith
• Jillian Smith
• Jillian Ann Shanahan Smith
• John Washburn Smith II, M.D.
• Jordyna Paige Smith
• Joshua Smith

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.