JACOB ANDERSON REISS (NPI# 1023103652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023103652 |
| Entity Type | Individual |
| Full Name | JACOB ANDERSON REISS |
| Credential | M.D. |
| Practice Address |
3325 N Interstate Ave Portland OR 97227-1022 |
| Mailing Address |
3325 N Interstate Ave Kaiser Permanente Interstate Medical Office West Portland OR 97227-1020 |
| Practice Telephone | 5033316596 |
| Practice Fax Number | 5033316320 |
| Mailing Telephone | 5038132000 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
G21401 | CA | Allopathic & Osteopathic Physicians |
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
WA MD00013839 | WA | Allopathic & Osteopathic Physicians |
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
OR MD08690 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619473287 | Jacob Philip Reiss | Student in an Organized Health Care Education/Training Program | 100 Lancaster Ave, Wynnewood, PA 19096 | 2018-04-03 |
| Street Address |
3325 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407807720 | Cheryl A Miranda | Genetic Counselor, MS | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2006-05-12 |
| 1003367657 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2016-10-19 |
| 1568814952 | Lindsey Moser | Pharmacist | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2016-07-08 |
| 1821449919 | Taben Main | Pharmacist | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2016-06-29 |
| 1457741068 | Audrey Nguyen | Pharmacist | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2015-02-03 |
| 1245665769 | Abbey Shoultz | Social Worker | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2013-09-04 |
| 1801153887 | Erin Schalles | Genetic Counselor, MS | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2012-04-16 |
| 1841556552 | Gary Kim | Anesthesiology | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2012-04-06 |
| 1215232871 | Marian J Morse | Genetic Counselor, MS | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2011-01-12 |
| 1245559129 | Lindsay Dawn Craft | Counselor | 3325 N Interstate Ave, Portland, OR 97227-1020 | 2010-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720407166 | Kimberly Ann Kripps | Medical Genetics | 3181 Sw Sam Jackson Park Rd, 4502/l103, Portland, OR 97239 | 2014-04-14 |
| 1417191081 | Nicoleta Cristina Voian | Medical Genetics | 4805 Ne Glisan St Ste 6n50, Portland, OR 97213-2933 | 2009-04-28 |
| 1326306721 | Andrea Klunder Petersen | Medical Genetics | 2801 N Gantenbein Ave Ste 2225, Portland, OR 97227-1623 | 2012-04-24 |
| 1558686394 | Caleb Charles Rogers | Medical Genetics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2010-04-05 |
| 1700025681 | Wojciech Krzysztof Wiszniewski | Medical Genetics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2009-02-17 |
| 1801054531 | Stephanie Esther Dukhovny | Medical Genetics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-05-29 |
| 1902012180 | Amy C Yang | Medical Genetics | 707 Sw Gaines St, Portland, OR 97239-2901 | 2007-05-15 |
| 1104976638 | Rosemarie Smith | Medical Genetics | 1577 Congress St, 2nd Floor, Portland, ME 04102-2169 | 2007-01-10 |
| 1730239153 | Wendy E Smith | Medical Genetics | 1577 Congress St, 2nd Floor, Portland, ME 04102-2169 | 2007-01-10 |
| 1912915471 | Robb Edwin Moses | Medical Genetics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-03 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.