MR. JACK ROBERT LENNON (NPI# 1194147454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194147454 |
| Entity Type | Individual |
| Full Name | MR. JACK ROBERT LENNON |
| Credential | EMT-B |
| Practice Address |
1535 N Williams Ave Portland OR 97227-1885 |
| Mailing Address |
232 Nw 6th Ave Portland OR 97209-3609 |
| Practice Telephone | 5032382067 |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 138276 | OR | Emergency Medical Service Providers |
| Street Address |
1535 N WILLIAMS AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053347591 | Andrew B Mendenhall | Family Medicine | 1535 N Williams Ave, Portland, OR 97227-1885 | 2006-06-25 |
| 1619576782 | Andrew Iokepa Kualaau | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-10-20 |
| 1679170377 | Holly Nicole Phillips | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-10-06 |
| 1326654039 | Zachary Nathan Starbuck | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-17 |
| 1770197071 | David Ali Jimenez | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-03 |
| 1720692122 | Brianna Michelle White | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-09-02 |
| 1669081816 | Sara Elizabeth Price | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-07-23 |
| 1295352979 | Anthony Michshon Hines II | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-06-29 |
| 1548882269 | Mary Ann Mukhin | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-05-15 |
| 1184253486 | Rachelle Lauren Sather | Registered Nurse | 1535 N Williams Ave, Portland, OR 97227-1885 | 2020-04-07 |
| 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 | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508474644 | Peter Lee | Emergency Medical Technician, Basic | 021 Sw Bancroft St, Portland, OR 97239-4064 | 2020-07-15 |
| 1447804570 | Elissa Burns | Emergency Medical Technician, Basic | 5806 Se Cesar E Chavez Blvd, Portland, OR 97202-7508 | 2019-07-26 |
| 1891136735 | Aram Novosel | Emergency Medical Technician, Basic | 51 Ne Grand Ave, Portland, OR 97232-2968 | 2013-07-08 |
| 1831373539 | Debra Rae Oden | Emergency Medical Technician, Basic | 8538 Sw Appleway, Portland, OR 97225 | 2007-12-18 |
| 1588659981 | Ambulance Corps of Portland & Vicinity | Emergency Medical Technician, Basic | 106 State St, Portland, PA 18351-0096 | 2005-09-13 |
| 1083120042 | Katherine Quatrano | Emergency Medical Technician, Basic | 949 Brighton Ave, Portland, ME 04102-1060 | 2017-12-28 |
| 1265867717 | Timothy O'neill | Emergency Medical Technician, Basic | 232 Nw 6th Ave, Portland, OR 97209-3609 | 2013-09-03 |
| 1063854255 | Christyl Beck | Emergency Medical Technician, Basic | 1535 N Williams Ave, Portland, OR 97227-1885 | 2013-07-29 |
| 1447576939 | Tracy M Rushing | Emergency Medical Technician, Basic | 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 2010-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174892210 | Central Cascades Fire & Ems | Emergency Medical Technician, Basic | 20400 Crescent Lake Hwy, Crescent Lake, OR 97733-7044 | 2011-12-19 |
| 1073803433 | Daniel A Marro | Emergency Medical Technician, Basic | 755 W Quinalt St, Springfield, OR 97477-2756 | 2011-04-19 |
| 1629693429 | Adrienne Barnes | Emergency Medical Technician, Basic | 961 Nw Hayes Ave Apt 24, Corvallis, OR 97330-4581 | 2020-06-08 |
| 1417456104 | Marc Ian Kraidman | Emergency Medical Technician, Basic | 900 Se Baker St, Mcminnville, OR 97128-6808 | 2018-02-08 |
| 1154832319 | Wendy Oshinski | Emergency Medical Technician, Basic | 2727 Leo Harris Pkwy, Eugene, OR 97401-8835 | 2017-10-16 |
| 1902281868 | Garrett Skelton | Emergency Medical Technician, Basic | 2200 Ne Neff Rd, #200, Bend, OR 97701-4283 | 2015-07-21 |
| 1831516772 | Sky Lakes Physician Services | Emergency Medical Technician, Basic | 2865 Daggett Ave, Klamath Falls, OR 97601-1106 | 2014-03-27 |
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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.