Individual provider Active NPI

Jessica Mia Soliven, BA IN SOCIOLOGY

  • Specialist
  • Gresham, OR
National Provider Identifier
1710166624
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
4101 NE Division St
Suite # 100
Gresham, OR 97030-4617
Phone
(503) 666-3808
Fax
(503) 666-6835
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

4101 NE Division St
Suite # 100
Gresham, OR 97030-4617

Mailing address

804 SE 139TH Ave
Portland, OR 97233-1956
Phone (503) 252-1437

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
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1710166624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SE 139TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331956",
            "telephone_number": "503-252-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST",
            "address_2": "SUITE # 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-3808",
            "fax_number": "503-666-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIVEN",
        "first_name": "JESSICA",
        "middle_name": "MIA",
        "credential": "BA IN SOCIOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.