Michelle Jackson, M.S., OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1034297 Issued in OR

Practice address

501 N Dixon St
Portland, OR 97227-1876

Phone

(530) 423-5135

NPI assigned

Sep 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Hallisey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1629471289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N DIXON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271876",
            "telephone_number": "503-916-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N DIXON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271876",
            "telephone_number": "530-423-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "1034297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "HALLISEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lloyd Chris Jackson, MCM, CADC I, CRM II
• Lydia Michelle Jackson
• Mallori A Jackson
• Melinda Ann Jackson
• Melissa T Jackson, MS HUMAN SERVICES
• Natalie Jo Jackson
• Natasha Marie Jackson
• Nicole Jackson
• Patricia Louise Jackson, RN
• Peter Jackson, M.D.

• Pediatric Occupational Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.