Emmett Jubilee Pennington-Guthrie, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

10032133 Issued in OR

Practice address

722 NE 162ND Ave
Portland, OR 97230-5760

Phone

(503) 408-4705

NPI assigned

Sep 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1619794708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 LESLIE ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760",
            "telephone_number": "503-408-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON-GUTHRIE",
        "first_name": "EMMETT",
        "middle_name": "JUBILEE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "OR",
            "license": "10032133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Penner, AU.D.
• Aubra Danielle Penner
• Sara Penner, LCSW
• Mark Edward Pennesi, MD PHD
• Alyssa Penning, MD
• Natalya Y Pennington, O.D.
• Pamela Joy Pennington, LMT, NCMMT
• Heather Michelle Penny, MD
• Jacki Penny
• Regina Penny

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.