Active NPI
Daniel Jaylin Patrick
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1780389833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C10264
- Practice address
- 3620 SE Powell Blvd Ste 102
Portland, OR 97202-1889 - Phone
- (206) 752-3715
- NPI assigned
- Mar 30, 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LH61643244 | WA | |
| Counselor | 101Y00000X | C10264 | OR | |
| Mental Health Counselor | 101YM0800X | C10264 | OR | Primary |
| Mental Health Counselor | 101YM0800X | 92900 | TX | |
| Counselor | 101Y00000X | 92900 | TX | |
| Mental Health Counselor | 101YM0800X | LH61643244 | WA |
Addresses
Primary practice location
3620 SE Powell Blvd Ste 102
Portland, OR 97202-1889
Mailing address
3620 SE Powell Blvd Ste 102
Portland, OR 97202-1889
Phone (206) 752-3715
Other practice location 1
3620 SE Powell Blvd Ste 102
Portland, OR 97202-1889
Phone (206) 752-3715
Other practice location 2
108 S Jackson St Ste 301
Seattle, WA 98104-2872
Phone (206) 752-3715
Other practice location 3
818 SW 3rd Ave # 221-1301
Portland, OR 97204-2405
Phone (206) 752-3715
Other practice location 4
2010 North Loop W Ste 240
Houston, TX 77018-8125
Phone (206) 752-3715
Other practice location 5
10260 SW Greenburg Rd Fl 4
Portland, OR 97223-5500
Phone (646) 941-7645
Other practice location 6
10350 N Vancouver Way # 64301
Portland, OR 97217-7530
Phone (206) 752-3715
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 |
|---|---|---|---|
| 92900 | TX | MD | Counselor |
| LH61643244 | WA | MD | Counselor |
| C10264 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1780389833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3620 SE POWELL BLVD STE 102",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972021889",
"telephone_number": "206-752-3715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3620 SE POWELL BLVD STE 102",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972021889",
"telephone_number": "206-752-3715"
}
],
"practiceLocations": [
{
"address_1": "3620 SE Powell Blvd Ste 102",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972021889",
"country_code": "US",
"telephone_number": "206-752-3715",
"fax_number": "360-295-8059",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 S Jackson St Ste 301",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981042872",
"country_code": "US",
"telephone_number": "206-752-3715",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "818 SW 3rd Ave # 221-1301",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972042405",
"country_code": "US",
"telephone_number": "206-752-3715",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2010 North Loop W Ste 240",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770188125",
"country_code": "US",
"telephone_number": "206-752-3715",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10260 SW Greenburg Rd Fl 4",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972235500",
"country_code": "US",
"telephone_number": "646-941-7645",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10350 N Vancouver Way # 64301",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972177530",
"country_code": "US",
"telephone_number": "206-752-3715",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATRICK",
"first_name": "DANIEL",
"middle_name": "JAYLIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-30",
"last_updated": "2026-03-27",
"certification_date": "2026-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "LH61643244",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "C10264",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C10264",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "92900",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "92900",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH61643244",
"primary": false
}
],
"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 Mar 27, 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.