Jason M Head

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

17-CRM-032 Issued in OR

Practice address

2602 Arbor Dr
West Linn, OR 97068-1104

Phone

(503) 387-3884

NPI assigned

Aug 19, 2015

Last updated

Dec 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jason Milton Head Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1619343027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 200",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451869",
            "fax_number": "503-208-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 ARBOR DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681104",
            "telephone_number": "503-387-3884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "726 W Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972093515",
            "country_code": "US",
            "telephone_number": "503-944-4410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 Main St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451842",
            "country_code": "US",
            "telephone_number": "971-386-3409",
            "fax_number": "503-723-6653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451869",
            "country_code": "US",
            "telephone_number": "971-386-3409",
            "fax_number": "503-208-2596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAD",
        "first_name": "JASON",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-5-14",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "17-CRM-032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "HEAD",
            "middle_name": "MILTON",
            "credential": "CADC1,CRM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Peer Specialist in West Linn, OR
• Providers in West Linn, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.