Active NPI
Jesse Paris Gorman
- Pharmacy Technician
- Portland, OR
National Provider Identifier
1730877481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 0011735
- Practice address
- 11190 SW Barnes Rd
Portland, OR 97225-5372 - Phone
- (503) 528-9121
- Fax
- (503) 628-4802
- NPI assigned
- Apr 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 0011735 | OR | Primary |
Addresses
Primary practice location
11190 SW Barnes Rd
Portland, OR 97225-5372
Mailing address
11190 SW Barnes Rd
Portland, OR 97225-5372
Phone (503) 528-9121
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0011735 | OR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682640000000",
"number": "1730877481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11190 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255372",
"telephone_number": "503-528-9121",
"fax_number": "503-628-4802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11190 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255372",
"telephone_number": "503-528-9121",
"fax_number": "503-628-4802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "JESSE",
"middle_name": "PARIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-28",
"last_updated": "2023-04-28",
"certification_date": "2023-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OR",
"license": "0011735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.