JASON SOUTHMAYD (NPI# 1730532649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730532649 |
| Entity Type | Individual |
| Full Name | JASON SOUTHMAYD |
| Credential | R.N. |
| Practice Address |
4105 Se International Way Ste 501 Milwaukie OR 97222-8855 |
| Mailing Address |
14600 Nw Cornell Rd Portland OR 97229-5442 |
| Practice Telephone | 5034963201 |
| Mailing Telephone | 5036453581 |
| Mailing Fax Number | 5036909605 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 201504773RN | OR | Nursing Service Providers |
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
201504773RN | OR | Nursing Service Providers |
| Street Address |
4105 SE INTERNATIONAL WAY STE 501 |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-8855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346490729 | Joshua Allen Furtado | Counselor | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2008-09-23 |
| 1356966345 | Matthew Burns | Counselor | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2020-06-15 |
| 1861016933 | Melissa Louise Barnett | Case Manager/Care Coordinator | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2020-06-03 |
| 1093365256 | Maria Briley | Registered Nurse | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2019-09-18 |
| 1376199026 | Anne Agriesti | Case Manager/Care Coordinator | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2019-08-16 |
| 1689227704 | Kylie Shay Mcdermott | Occupational Therapist | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2019-07-17 |
| 1427614346 | Madison Marie Cock | Case Manager/Care Coordinator | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2019-05-15 |
| 1942735675 | Kevin Christaldi | Counselor | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2017-05-01 |
| 1245777457 | Katie Sichley | Counselor | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2017-01-25 |
| 1417315201 | Cliff Smithers | Peer Specialist | 4105 Se International Way Ste 501, Milwaukie, OR 97222-8855 | 2016-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932747607 | Kendall Clayton Karch | Registered Nurse | 30 Ne Mlk Jr Blvd, Portland, OR 97232-2941 | 2019-12-12 |
| 1003315045 | Ryan Tateishi | Registered Nurse | 966 12th St Se Ste 110, Salem, OR 97302-2860 | 2018-02-05 |
| 1952815532 | Shane Martin | Registered Nurse | 2110 Augusta St, Eugene, OR 97403-2202 | 2017-11-19 |
| 1811349160 | Aleksey Maksimov | Registered Nurse | 4757 Parkview Dr Apt B, Lake Oswego, OR 97035-2426 | 2016-07-11 |
| 1366832461 | Maria Liotta Shindler | Registered Nurse | 6201 Ne Carillion Dr, Hillsboro, OR 97124-8590 | 2015-01-27 |
| 1346651882 | Holly Marie Matthews | Registered Nurse | 788 Saint Charles Pl, Hood River, OR 97031-8785 | 2014-05-19 |
| 1376987404 | Helen Erika Horst | Registered Nurse | 2020 State Rd, Mosier, OR 97040 | 2013-04-19 |
| 1598013997 | Trina Marie Espiasse | Registered Nurse | 47940 Sw Ihrig Rd, Forest Grove, OR 97116-7329 | 2012-08-16 |
| 1275810665 | Esther Gabrielle Rosengarten | Registered Nurse | 1020 Sw Taylor St Ste 745, Portland, OR 97205-2505 | 2011-11-14 |
| 1336436823 | Susan Elizabeth Stone | Registered Nurse | 19333 Sw Laurelhurst Way, Bend, OR 97702-3192 | 2011-07-05 |
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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.