Jonna Robertsen

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

104463 Issued in OR

Practice address

2410 SE 10TH Ave
Portland, OR 97214-4624

Phone

(503) 383-9643

NPI assigned

Aug 27, 2021

Last updated

Jun 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jay Robertsen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1790452589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SE 10TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144624",
            "telephone_number": "503-383-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SE 10TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144624",
            "telephone_number": "503-383-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSEN",
        "first_name": "JONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "104463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "ROBERTSEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard Rhett Roberts, MSW, CADC
• Samuel Joseph Buffington Roberts, DO
• Shannon Noel Roberts
• Stephen S Roberts, M.D.
• Teresa Roberts
• Lydia Naomi Robertshaw
• Cassandra Rose Robertson-Binkley
• Jenna Evelyn Robertson-Witt, MSW, CSWA
• Amy Robertson
• Andrew Grant Robertson

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.