JACOB PETER HAUPTMAN (NPI# 1285802850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285802850 |
| Entity Type | Individual |
| Full Name | JACOB PETER HAUPTMAN |
| Credential | P.A.-C |
| Practice Address |
1321 Ne 99th Ave #200 Portland OR 97220-9436 |
| Practice Telephone | 5032154250 |
| Mailing Telephone | 5032154250 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2020-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
161825 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA20495 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
002042 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1321 NE 99TH AVE #200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-9436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346234606 | Marina Mezey | Family Medicine | 1321 Ne 99th Ave, Suite 200, Portland, OR 97220-9436 | 2005-09-01 |
| 1740697432 | Adam Churey | Physician Assistant | 1321 Ne 99th Ave, Suite 100, Portland, OR 97220-9436 | 2014-07-15 |
| 1710307715 | Providence Health & Services - Oregon | Clinic/Center | 1321 Ne 99th Ave, Suite 110a, Portland, OR 97220-9436 | 2014-04-17 |
| 1497190409 | Keevin Bybee | Family Medicine | 1321 Ne 99th Ave, Ste 100, Portland, OR 97220-9436 | 2013-05-03 |
| 1588917009 | Claire-alyce Rochelle Gobble | Family Medicine | 1321 Ne 99th Ave, Suite 100, Portland, OR 97220-9436 | 2012-10-22 |
| 1790054831 | Elise J Mahoney | Nurse Practitioner | 1321 Ne 99th Ave, Suite 100, Portland, OR 97220-9436 | 2011-12-19 |
| 1649582610 | Yana I Bojilova Norman | Nurse Practitioner | 1321 Ne 99th Ave, Suite 100, Portland, OR 97220-9437 | 2010-07-07 |
| 1619290863 | Wajma Niazi | Physician Assistant | 1321 Ne 99th Ave, Ste 100, Portland, OR 97220-9437 | 2010-03-02 |
| 1326377235 | Vantrang Thi Nguyen | Family Medicine | 1321 Ne 99th Ave, Suite 100, Portland, OR 97220-9436 | 2009-12-24 |
| 1255566220 | Amber M Clark | Family Medicine | 1321 Ne 99th Ave, Ste 100, Portland, OR 97220-9436 | 2009-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073081428 | Ishah Marie Price | Physician Assistant | 30 Preble St Apt 663, Portland, ME 04101-4939 | 2018-11-04 |
| 1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
| 1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1871982975 | Colin Storz | Physician Assistant | 3623 N Borthwick Ave, Portland, OR 97227-1218 | 2015-01-13 |
| 1275888729 | Stephanie Calvin | Physician Assistant | 782 College St, Portland, TN 37148-2120 | 2012-07-20 |
| 1174800031 | Carolyn Frances Farrell | Physician Assistant | 450 N Graham St, Portland, OR 97227-1682 | 2011-11-07 |
| 1316130198 | Ronald W Kessler | Physician Assistant | 632 Brighton Ave, Portland, ME 04102-1017 | 2007-08-24 |
| 1124210778 | Honey E.l. Marques | Physician Assistant | 16279 Se Division St, Portland, OR 97236-1971 | 2007-08-16 |
| 1124177902 | Dmitriy Shore | Physician Assistant | 10305 Sw Park Way Ste 300, Portland, OR 97225-5033 | 2007-01-09 |
| 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.