Jacob E. Creviston, DNP, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201405518NP-PP Issued in OR

Practice address

1308 NW 20TH Ave Ste 8
Portland, OR 97209-1607

Phone

(971) 213-5986

Fax

(503) 405-8124

NPI assigned

Sep 18, 2014

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jake Creviston Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Project Quest

  dba Quest Center for Integrative Health

  • Specialist
  • Portland, OR
  • NPI 1134458052
  NPD (past)

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1528460813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 NW HOYT ST UNIT 5482",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972088099",
            "telephone_number": "971-213-5986",
            "fax_number": "503-405-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 NW 20TH AVE STE 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091607",
            "telephone_number": "971-213-5986",
            "fax_number": "503-405-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVISTON",
        "first_name": "JACOB",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201405518NP-PP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200841169RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "CREVISTON",
            "prefix": "DR.",
            "credential": "DNP, RN, PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Crestview Recovery Services, LLC
• Crestview Recovery Services, LLC
• Emily Creswick, LPN
• Joachim Creten, MASSAGE THERAPIST
• Kaecee Creveling, L.AC., MACOM
• Criag W. Calhoun MD PC
• Michaela Leanne Cribb, NP
• Lindsey Crider, RN, BSN
• Carrie Eileen Crimin, BSN, L.AC.
• Kate Crimmins, MS, CF-SLP

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.