Individual provider Active NPI

Jessica Moore

  • Professional Counselor
  • Bend, OR
National Provider Identifier
1780156729
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
296 SW Columbia St
Bend, OR 97702-1020
Phone
(541) 550-7940
NPI assigned
Dec 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

296 SW Columbia St
Bend, OR 97702-1020

Mailing address

19789 Dry Canyon Ave
Bend, OR 97702-3034
Phone (503) 487-7885

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

NPI Registry JSON

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1780156729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19789 DRY CANYON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023034",
            "telephone_number": "503-487-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 SW COLUMBIA ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021020",
            "telephone_number": "541-550-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-31",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.