Donna Lianne Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2081 Issued in OR

Practice address

4035 Mercantile Dr
Suite 108
Lake Oswego, OR 97035-2546

Phone

(503) 216-2788

NPI assigned

May 31, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942401351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11546 SW LAKEVIEW TER",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972237859",
            "telephone_number": "503-524-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 108",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-216-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DONNA",
        "middle_name": "LIANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ipostal LLC
• Richard C Irvine Jr., LMT
• Scot Shoichi Itomura, PA-C
• J M Bussanich, LLC
• Ali Nicole Jackson
• Alexander Matthew Andrew Jameson, LMT
• Janice M. Johnson Counseling
• Janice Modesitt LMT
• Mark Stephen Jardini, MD
• Alexis Jarmer

• Physical Therapist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.