Individual provider Active NPI

Jennifer Opal Rowan, PTA

  • Physical Therapy Assistant
  • Portland, OR
National Provider Identifier
1881502565
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA003104 Issued in WV
Practice address
12441 SE Stark St
Portland, OR 97233-1053
Phone
(503) 255-7040
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X CP061995A OR
Physical Therapy Assistant 225200000X PTA003104 WV Primary

Addresses

Primary practice location

12441 SE Stark St
Portland, OR 97233-1053

Mailing address

126 Koncer Dr
Martinsburg, WV 25404-1309
Phone (301) 302-2399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1881502565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 KONCER DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254041309",
            "telephone_number": "301-302-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12441 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331053",
            "telephone_number": "503-255-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWAN",
        "first_name": "JENNIFER",
        "middle_name": "OPAL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "CP061995A",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "PTA003104",
            "primary": true
        }
    ],
    "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 Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.