Individual provider Active NPI

Jeffrey R Gomez

  • Case Manager/Care Coordinator
  • Vancouver, WA
National Provider Identifier
1588578884
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2410 Grand Blvd
Vancouver, WA 98661-4630
Phone
(360) 226-7656
Fax
(360) 226-7656
NPI assigned
Oct 1, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X WA Primary
Peer Specialist 175T00000X WA

Addresses

Primary practice location

2410 Grand Blvd
Vancouver, WA 98661-4630

Mailing address

2410 Grand Blvd
Vancouver, WA 98661-4630
Phone (360) 226-7656

Other practice location 1

3214 St Johns Blvd
Vancouver, WA 98661-3725
Phone (360) 226-7656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1588578884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 GRAND BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614630",
            "telephone_number": "360-226-7656",
            "fax_number": "360-226-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 GRAND BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614630",
            "telephone_number": "360-226-7656",
            "fax_number": "360-226-7656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3214 St Johns Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986613725",
            "country_code": "US",
            "telephone_number": "360-226-7656",
            "fax_number": "360-226-7656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.