NPIMap

Organization Active NPI

NW Psychiatric & Mental Health Services

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1851725709
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
201391588NP-PP Issued in OR
Legal business name
NW PSYCHIATRIC & MENTAL HEALTH SERVICES
Practice address
9155 SW Barnes Rd
Suite 418
Portland, OR 97225-6625
Phone
(503) 284-8841
NPI assigned
Aug 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Jean A Daniels, PMHNPNPI 1558490441
Title
Owner
Phone
(971) 270-0995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 201391588NP-PP OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd
Suite 418
Portland, OR 97225-6625

Mailing address

3439 NE Sandy Blvd
PMB 375
Portland, OR 97232
Phone (503) 284-8841

Other names 1

  • Jean A Daniels Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140312000916 OR Part B Supplier - Clinic/Group Practice 9032349139 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

9155 SW Barnes Rd
Ste 418
Portland, OR 97225
Phone (503) 292-3604

5319 SW Westgate Dr
Ste 109
Portland, OR 97221
Phone (971) 270-0995

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1851725709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD",
            "address_2": "PMB 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-284-8841",
            "fax_number": "503-282-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "SUITE 418",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-284-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW PSYCHIATRIC & MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-270-0995",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "201391588NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jean A Daniels",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.