Active NPI
Jeanine Angel Comstock, QMHA
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1508364902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- A14582
- Practice address
- 847 NE 19TH Ave Ste 100
Portland, OR 97232-2684 - Phone
- (971) 222-7067
- NPI assigned
- Jan 31, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | A14582 | OR | Primary |
Addresses
Primary practice location
847 NE 19TH Ave Ste 100
Portland, OR 97232-2684
Mailing address
PO Box 8459
Portland, OR 97207-8459
Phone (971) 222-7067
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 |
|---|---|---|---|
| A14582 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1508364902",
"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",
"telephone_number": "971-222-7067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE STE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322684",
"telephone_number": "971-222-7067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMSTOCK",
"first_name": "JEANINE",
"middle_name": "ANGEL",
"name_prefix": "Ms.",
"credential": "QMHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-31",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "A14582",
"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 May 14, 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.