Individual provider Active NPI

Jordan Ginn

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1679260806
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO.OP.70128331 Issued in WA
Practice address
12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055
Phone
(800) 813-2000
NPI assigned
Apr 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO231096 OR
Family Medicine Physician 207Q00000X DO.OP.70128331 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031

Other practice location 1

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (503) 333-0711

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1679260806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12607 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846055",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 Waianuenue Ave",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967202089",
            "country_code": "US",
            "telephone_number": "503-333-0711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINN",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO231096",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "DO.OP.70128331",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.