Active NPI
Jason Derico, N.D.
- Naturopath
- Beaverton, OR
National Provider Identifier
1265804652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 3026
- Practice address
- 4757 SW 141St Ave
Beaverton, OR 97005-3750 - Phone
- (503) 610-6924
- NPI assigned
- Oct 23, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | 3026 | OR | Primary |
Addresses
Primary practice location
4757 SW 141St Ave
Beaverton, OR 97005-3750
Mailing address
4757 SW 141St Ave
Beaverton, OR 97005-3750
Phone (435) 764-7725
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3026 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445558400000",
"number": "1265804652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4757 SW 141ST AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053750",
"telephone_number": "435-764-7725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4757 SW 141ST AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053750",
"telephone_number": "503-610-6924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERICO",
"first_name": "JASON",
"credential": "N.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-23",
"last_updated": "2015-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "3026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.