Individual provider Active NPI

Jaide Ashleigh Farr

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1669060810
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO231116 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 418-5700
Fax
(503) 418-5704
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO231116 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-5700

Other practice location 1

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618004483 OR Practitioner - Pediatric Medicine 5092177634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509

3178 SW 12TH Ave
Portland, OR 97239-3147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: jfarr160864@direct.ohsu.edu

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1669060810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "541-259-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARR",
        "first_name": "JAIDE",
        "middle_name": "ASHLEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO231116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.