DR. JAN M DEROEST (NPI# 1114106028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114106028 |
| Entity Type | Individual |
| Full Name | DR. JAN M DEROEST |
| Credential | PSY.D. |
| Practice Address |
350 Sw 30th Ct Troutdale OR 97060-3143 |
| Practice Telephone | 5034753274 |
| Mailing Telephone | 5034753274 |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2009-07-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1842 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY 00003927 | WA | Behavioral Health & Social Service Providers |
| Street Address |
350 SW 30TH CT |
| City | TROUTDALE |
| State | OR |
| Zip Code | 97060-3143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861921124 | Kayla Michelle Stewart | Doula | 424 Se 19th St, Troutdale, OR 97060 | 2017-06-08 |
| 1467856955 | Meghan Ellen Revoir Bennett | Naturopath | 330 Se 3rd Street, Troutdale, OR 97060 | 2014-10-13 |
| 1699012310 | Scott C Williams | Pharmacist | 22855 N.e. Parklane, Wood Village, OR 97060 | 2013-01-15 |
| 1285888636 | Dan E. Cox | Counselor | 107 E. Historic Columbia River Hwy, Suite 207, Troutdale, OR 97060 | 2008-11-12 |
| 1356592596 | Emily J White | Pulmonary Function Technologist | 735 Sw 14th St, Troutdale, OR 97060 | 2008-10-07 |
| 1497905772 | Fred Meyer | Pharmacist | 22855 Ne Parklane, Wood Village, OR 97060 | 2008-09-24 |
| 1104072057 | Sharon Brennan | Nurse Practitioner | 2800 Sw 257th Avenue, Columbia View Family Health Center, Troutdale, OR 97060 | 2008-08-12 |
| 1902094386 | Steven Gary Cranford | Chiropractor | 1530 Sw 257th Dr., Troutdale, OR 97060 | 2007-10-10 |
| 1750581062 | Gresham-troutdale Family Medical Center | Non-Pharmacy Dispensing Site | 1700 Sw 27th Ave, Troutdale, OR 97060 | 2007-07-24 |
| 1710181755 | Valerie Kay Robertson | Specialist | 3703 Se 39th, Portland, OR 97060 | 2007-06-13 |
| Find all providers in zip 97060 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306456058 | Southern Oregon Cbt LLC | Psychologist | 690 G St Ste C, Jacksonville, OR 97530-3208 | 2020-08-07 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1497377188 | Lois Michaud, Ph.d. | Psychologist | 570 Lawrence St Ste 106, Eugene, OR 97401-2586 | 2020-05-15 |
| 1871114793 | Lola White Psyd LLC | Psychologist | 388 State St Ste 704, Salem, OR 97301-4023 | 2020-05-01 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1659916401 | Northwest Child Assessment, LLC | Psychologist | 8228 Sw 171st Pl, Beaverton, OR 97007-6787 | 2019-11-14 |
| 1407498918 | Skyhook Fitness | Psychologist | 12008 Sw Garden Pl, Tigard, OR 97223-8263 | 2019-10-16 |
| 1720639958 | Steven C Schoger Psy D LLC | Psychologist | 10 Crater Lake Ave Ste 21, Medford, OR 97504-7445 | 2019-09-29 |
| Find all providers with the same taxonomy | ||||
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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.