Jorge Alejandro Reveron, ND

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4395 Issued in OR

Practice address

9735 SW Shady LN Ste 303
Tigard, OR 97223-5481

Phone

(503) 594-7373

Fax

(888) 346-7793

NPI assigned

Feb 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1851892830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 PACIFIC AVE APT 206",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971163135",
            "telephone_number": "503-406-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 SW SHADY LN STE 303",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235481",
            "telephone_number": "503-594-7373",
            "fax_number": "888-346-7793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1837 Pacific Ave Apt 206",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971163135",
            "country_code": "US",
            "telephone_number": "503-406-8450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVERON",
        "first_name": "JORGE",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "17-1683",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Tigard, OR
• Providers in Tigard, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.