JENNIFER WALDO (NPI# 1245687789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245687789 |
| Entity Type | Individual |
| Full Name | JENNIFER WALDO |
| Practice Address |
805 Se 151st Ave Portland OR 97233-2916 |
| Practice Telephone | 9712717270 |
| Practice Fax Number | 9713026055 |
| Mailing Telephone | 9712717270 |
| Mailing Fax Number | 9713026055 |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2016-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053941583 | Jennifer Waldo | Counselor | 5909 West Loop S Ste 557, Bellaire, TX 77401-2404 | 2020-01-23 |
| Street Address |
805 SE 151ST AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134384688 | Jamie Deruyter | Counselor | 805 Se 151st Ave, Portland, OR 97233-2916 | 2008-07-24 |
| 1740895762 | Elisabeth Herzog | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-09-15 |
| 1255943106 | Katherine Colleen Pacheco | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2020-08-21 |
| 1346885019 | Timothy Sims | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-17 |
| 1629612411 | Shannon Marie Stronach | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-11-05 |
| 1477194330 | Daneen Pray | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-10-02 |
| 1639720998 | Paula Keyth | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-09-26 |
| 1376001792 | Jordan Alexander Niles | Case Manager/Care Coordinator | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-03-05 |
| 1619434743 | Joel T Kirkpatrick | Peer Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2019-02-25 |
| 1588132401 | Chase Steven Hardt | Psychiatric Residential Treatment Facility | 805 Se 151st Ave, Portland, OR 97233-2916 | 2018-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| 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.