Jeremy Patrick Boal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L15438 Issued in OR

Practice address

620 NE 2ND St
Gresham, OR 97030-7514

Phone

(971) 274-3757

Fax

(503) 912-5740

NPI assigned

Jul 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1396734364

  OR

  Medicare reassignment NPD
• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1174979934
  NPD
• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1942747761
  NPD

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1730814005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NE 2ND ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307514",
            "telephone_number": "971-274-3757",
            "fax_number": "503-912-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAL",
        "first_name": "JEREMY",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L15438",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024023364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Marian Blake, PT
• Jared Block, PHARMD
• Melanie J Block, LD
• Stephen Matthew Block, DPT
• Blue Lake Oral and Maxillofacial Surgery, PC
• Bodies in Balance Chiropractic LLC
• Bodywork Massage Inc.
• Caitlynn Claire Didlick Bohman, LAC, DACM, MACOM
• Melissa Anne Bohnstedt, MS, CCC-SLP
• David Michael Bohrer, DC

• All providers in Gresham, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.