Individual provider Active NPI

Jor-El Zajatz

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1407312465
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C5195 Issued in OR
Practice address
1923 NE Broadway St Unit 7
Portland, OR 97232-1501
Phone
(503) 563-0563
NPI assigned
Feb 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C5195 OR Primary

Addresses

Primary practice location

1923 NE Broadway St Unit 7
Portland, OR 97232-1501

Mailing address

3716 NE 78TH Ave
Portland, OR 97213-6440
Phone (267) 629-9952

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

LicenseStateTypeSpecialty
C5195ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1407312465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 NE 78TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136440",
            "telephone_number": "267-629-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 NE BROADWAY ST UNIT 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321501",
            "telephone_number": "503-563-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJATZ",
        "first_name": "JOR-EL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5195",
            "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 17, 2023; 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.