Individual provider Active NPI

Jessica L Wilson, DO

  • Family Medicine Physician
  • Beaverton, OR
National Provider Identifier
1770024697
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO210423 Issued in OR
Practice address
6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone
(503) 430-1777
Fax
(503) 372-5119
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO210423 OR Primary

Addresses

Primary practice location

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487

Mailing address

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone (503) 430-1777

Other names 1

  • Jessica L Hu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220606001125 OR Practitioner - Family Practice 2163756628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

Hospital & facility affiliations

  • Hillsboro Health and Rehabilitation Nursing home, Hillsboro, OR, CCN 385217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince May 25, 2022 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
CRM Physicians, LLC Family Medicine CurrentSince Mar 1, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince May 25, 2022 Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

1960 NW 167th Pl
Ste 100
Beaverton, OR 97006
Phone (503) 672-6000

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1770024697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777",
            "fax_number": "503-372-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777",
            "fax_number": "503-372-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO210423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HU",
            "middle_name": "L",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.