Individual provider Active NPI

Jonathan Bale

  • Psychiatry Physician
  • Corvallis, OR
National Provider Identifier
1952765349
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
PG183616 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone
(541) 768-4906
NPI assigned
Apr 11, 2016
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X PG183616 OR Primary

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-5472

Mailing address

905 Apache Dr
Mount Vernon, WA 98273-5724

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210709001580 OR Practitioner - Psychiatry 7416227939 Reassigns benefits to 1 organization
I20210712000300 WA Practitioner - Psychiatry 7416227939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12607 SE Mill Plain Blvd
Vancouver, WA 98684-4098
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 26, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 26, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 26, 2021 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

12607 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: jbale135321@samhealth.direct-ci.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1952765349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 APACHE DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-768-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALE",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "PG183616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "12607 SE Mill Plain Blvd",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986846055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.