Jacqueline Holden

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R5764 Issued in OR

Practice address

15369 NW Marie Way
Portland, OR 97229-6967

Phone

(971) 238-2973

NPI assigned

Nov 12, 2007

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

• Jacqueline Duvoisin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590278400000",
    "number": "1689854275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15369 NW MARIE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296967",
            "telephone_number": "971-238-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15369 NW MARIE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296967",
            "telephone_number": "971-238-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R5764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "DUVOISIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Kevin Holdeman, LPC
• Allen Roy Holden
• Amanda Holden
• Donna Fay Holden, PA-C
• Ernest Holden, D.M.D.
• Jeremy P Holden, MD
• Karri Holden
• Margaret Holden, L.AC.
• Marion Holden, D.M.D.
• Sandra Holden, WHCNP

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2020; 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.