Individual provider Active NPI

Jesse L Morris, PMHNP, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clackamas, OR
National Provider Identifier
1679351993
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10016058 Issued in OR
Practice address
12901 SE 97TH Ave Ste 105
Clackamas, OR 97015-7902
Phone
(503) 912-4788
Fax
(503) 912-4787
NPI assigned
Sep 18, 2023
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10016058 OR Primary

Addresses

Primary practice location

12901 SE 97TH Ave Ste 105
Clackamas, OR 97015-7902

Mailing address

12901 SE 97TH Ave Ste 105
Clackamas, OR 97015-7902
Phone (503) 912-4788

Other identifiers 1

IdentifierTypeStateIssuer
500827329MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231117001438 OR Practitioner - Nurse Practitioner 6901253681 Reassigns benefits to 1 organization
I20240429001118 WA Practitioner - Nurse Practitioner 6901253681

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cognitive Care Medical Group LLCGroup PAC ID 6103101498, 3 clinicians

Practice addresses (Care Compare)

12901 SE 97TH Ave
Suite 105
Clackamas, OR 97015-7902
Phone (503) 912-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10016058ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest IV, LLC Current Accepting new patients
Cognitive Care Medical Group LLC Psychiatric/Mental Health CurrentSince Nov 10, 2025 Accepting new patients
Deep Insight PLLC Psychiatric/Mental Health PastSince Sep 5, 2023 Accepting new patients

Locations

16100 NW Cornell Rd
Ste 190
Beaverton, OR 97006
Phone (888) 830-6088

2255 NW Shevlin Park Rd
Ste 110
Bend, OR 97703
Phone (541) 728-2525

12901 SE 97th Ave
Ste 105
Clackamas, OR 97015
Phone (503) 655-8045

6400 SE Lake Rd
Ste 135
Portland, OR 97222
Phone (888) 830-6088

6400 SE Lake Rd
Ste 155
Portland, OR 97222
Phone (503) 447-3285

6400 SE Lake Rd
Ste 430
Portland, OR 97222

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1679351993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 SE 97TH AVE STE 105",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157902",
            "telephone_number": "503-912-4788",
            "fax_number": "503-912-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 SE 97TH AVE STE 105",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157902",
            "telephone_number": "503-912-4788",
            "fax_number": "503-912-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JESSE",
        "middle_name": "L",
        "credential": "PMHNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10016058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500827329",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.