MS. MADELINE JACOBS (NPI# 1447622477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447622477 |
| Entity Type | Individual |
| Full Name | MS. MADELINE JACOBS |
| Credential | PMHNP, RN, BSN |
| Practice Address |
1535 N Williams Ave Portland OR 97227-1885 |
| Mailing Address |
1625 Schrader Blvd Los Angeles CA 90028-6213 |
| Practice Telephone | 5032382067 |
| Practice Fax Number | 5032382004 |
| Mailing Telephone | 3239937500 |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2019-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
201504614RN | OR | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201809753NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3415 Se Powell Blvd, Portland, OR 972023371 | 5032349591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972066173 | Madeline Jacobs | Student in an Organized Health Care Education/Training Program | 80 Seymour St, Hartford, CT 06102-8000 | 2019-04-13 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
| 1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
| 1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
| 1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
| 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.