Active NPI
Sophia Jaeger-Manson, PSYD
- Forensic Psychologist
- Salem, OR
National Provider Identifier
1689200784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 2910
- Practice address
- 2600 Center St NE
Salem, OR 97301-2669 - Phone
- (503) 947-8093
- NPI assigned
- Mar 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 2910 | OR | Primary |
Addresses
Primary practice location
2600 Center St NE
Salem, OR 97301-2669
Mailing address
3370 Elder St NW
Salem, OR 97304-3294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 7, 2025 through Nov 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2910 | OR | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584662400000",
"number": "1689200784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3370 ELDER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973043294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012669",
"telephone_number": "503-947-8093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAEGER-MANSON",
"first_name": "SOPHIA",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-20",
"last_updated": "2020-03-20",
"certification_date": "2020-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "OR",
"license": "2910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.