Jennifer Lyn Gillette

Primary specialty

Social WorkerTaxonomy code 104100000X

License

RC60020485 Issued in WA

Practice address

3550 SE Woodward St
Portland, OR 97202-1552

Phone

(503) 348-7378

NPI assigned

Oct 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Lyn Gillette 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": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1710139431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1809",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970350009",
            "telephone_number": "503-729-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 SE WOODWARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021552",
            "telephone_number": "503-348-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "RC60020485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED COUNSELOR",
            "identifier": "RC60020485",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GILLETTE",
            "middle_name": "LYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Isabella Eileen Gillespie, CRM
• Melissa Gillespie
• Robert J Gillespie, MD
• Shelley Gillespie, LCSW
• Darren L. Gillette, MD
• Adrienne Rosanne Gilley
• Mary Tolliver Gilley, ANP-PP
• Sandra Gillgam
• Sara Joy Gillham, ND
• Heather Gilliam

• Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.