Jessica L Barber, LMT
Individual provider Active NPI Specialist · Portland, OR
NPI 1528291622 · NPPES record last updated Aug 23, 2013
Key facts
- NPI
- 1528291622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 7645 (OR)
- Practice address
- 4511 SE Hawthorne Blvd Ste 214
Portland, OR 97215-3170 - Phone
- (503) 241-0042
- NPI assigned
- Aug 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7645 | OR | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 7645 | OR | Yes |
Addresses
Primary practice location
4511 SE Hawthorne Blvd Ste 214
Portland, OR 97215-3170
Mailing address
4511 SE Hawthorne Blvd Ste 214
Portland, OR 97215-3170
Phone (503) 241-0042
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.