Individual provider Active NPI

Jonathan Reece Walker, MA

  • Mental Health Counselor
  • Milwaukie, OR
National Provider Identifier
1306077896
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10202 SE 32ND Ave
504
Milwaukie, OR 97222-3610
Phone
(503) 496-1190
Fax
(503) 496-1195
NPI assigned
Jul 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10202 SE 32ND Ave
504
Milwaukie, OR 97222-3610

Mailing address

10202 SE 32ND Ave
504
Milwaukie, OR 97222-3610
Phone (503) 496-1190

Other identifiers 1

IdentifierTypeStateIssuer
123190MedicaidOR

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1306077896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "504",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223610",
            "telephone_number": "503-496-1190",
            "fax_number": "503-496-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "504",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223610",
            "telephone_number": "503-496-1190",
            "fax_number": "503-496-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JONATHAN",
        "middle_name": "REECE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.