Individual provider Active NPI

Jennifer Diane Manske, RN

  • Psychiatric/Mental Health Registered Nurse
  • Portland, OR
National Provider Identifier
1891161915
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
201392661 Issued in OR
Practice address
847 NE 19TH Avenue
Suite 100
Portland, OR 97232
Phone
(503) 238-0769
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychiatric/Mental Health Registered Nurse 163WP0808X 201392661 OR Primary

Addresses

Primary practice location

847 NE 19TH Avenue
Suite 100
Portland, OR 97232

Mailing address

PO Box 8459
Portland, OR 97207
Phone (503) 238-0769

Other names 1

  • Jennifer Diane Cary Other name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201392661ORMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1891161915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97207",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVENUE",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-238-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSKE",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201392661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CARY",
            "middle_name": "DIANE",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 12, 2015; 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.