Jack Wilkinson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000105108 Issued in OR

Practice address

1825 NE Glisan St
Portland, OR 97232-2844

Phone

(503) 963-7676

NPI assigned

Mar 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Paula Wilkinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cascadia Health

  dba Cascadia Behavioral Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1336196401
  NPD (past)

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1720736234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322844",
            "telephone_number": "503-963-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000105108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "WILKINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamera Wilkins
• Timothy Wilkins, QMHP-C
• David B Wilkinson, M.D.
• Emily Wilkinson
• Ian Wilkinson, LAC
• Janette Marie Wilkinson, RN, PMHNP-BC
• Jay Wilkinson
• Lindsay Anne Marie Wilkinson, ND, LAC
• Nicole Michelle Wilkinson, ND
• Rylee Wilkinson, BS, CHES

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.