Active NPI
Jenna Pierce, MS
- Mental Health Counselor
- Beaverton, OR
National Provider Identifier
1689970253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4510 SW Hall Blvd
Beaverton, OR 97005-0504 - Phone
- (503) 644-1171
- Fax
- (503) 914-0335
- NPI assigned
- Jan 31, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
4510 SW Hall Blvd
Beaverton, OR 97005-0504
Mailing address
6 Centerpointe Dr Ste 200
Lake Oswego, OR 97035-8660
Phone (503) 644-1171
Other practice location 1
10373 NE Hancock St
Suite 200
Portland, OR 97220-3873
Phone (503) 253-6754 ext. 132
Other names 1
- Jenna Fahlander
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Medical Group, PC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61288
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.
-
- Clinic/Center
- Lake Oswego, OR
- NPI 1477636561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1689970253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 CENTERPOINTE DR STE 200",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970358660",
"telephone_number": "503-644-1171",
"fax_number": "503-914-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4510 SW HALL BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970050504",
"telephone_number": "503-644-1171",
"fax_number": "503-914-0335"
}
],
"practiceLocations": [
{
"address_1": "10373 NE Hancock St",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972203873",
"country_code": "US",
"telephone_number": "503-253-6754 x132",
"fax_number": "503-253-8020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PIERCE",
"first_name": "JENNA",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNA",
"last_name": "FAHLANDER",
"credential": "MS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.