Individual provider Active NPI

Jade Maniscalco

  • Adult Companion
  • Portland, OR
National Provider Identifier
1396147369
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
7003 SE Woodstock Blvd
Portland, OR 97206-5940
Phone
(503) 719-4776
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X Primary

Addresses

Primary practice location

7003 SE Woodstock Blvd
Portland, OR 97206-5940

Mailing address

PO Box 8459
Portland, OR 97207-8459

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

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1396147369",
    "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": "7003 SE WOODSTOCK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972065940",
            "telephone_number": "503-719-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISCALCO",
        "first_name": "JADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.