JEREMY MOORE (NPI# 1760633622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760633622 |
| Entity Type | Individual |
| Full Name | JEREMY MOORE |
| Credential | AAOT |
| Practice Address |
3550 Se Woodward St Portland OR 97202-1552 |
| Mailing Address |
740 Ne 53rd Ave Apt 33 Portland OR 97213-3164 |
| Practice Telephone | 5035178663 |
| Practice Fax Number | 5039434994 |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659644821 | Jeremy Scott Moore | Social Worker | 106 Algedon Dr, Bessemer City, NC 28016-2857 | 2012-02-17 |
| 1205128451 | Jeremy Clint Moore | Psychiatry & Neurology | 501 Bishop Lane, University of South Alabama, Department of Psychiatry, Mobile, AL 36608 | 2011-05-06 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1528419736 | Jeremy Moore | Social Worker | 1101 Weaver Dairy Rd, Suite 103, Chapel Hill, NC 27514-1791 | 2016-06-29 |
| 1245596022 | Jeremy Moore | Emergency Medicine | 1 Wyoming St, Dayton, OH 45409-2722 | 2012-04-06 |
| 1265676274 | Jeremy Paul Moore | Pediatrics | 10833 Le Conte Ave, B265, Los Angeles, CA 90095-3075 | 2009-04-22 |
| 1295877140 | Jeremy Patrick Moore | Anesthesiology | 9300 Dewitt Loop, Fort Belvoir, VA 22060-5285 | 2007-02-13 |
| 1184707143 | Jeremy Adam Moore | Otolaryngology | 3650 W Rock Creek Rd, Suite 110, Norman, OK 73072-2202 | 2006-10-23 |
| 1548360290 | Jeremy Emmett Moore | Dentist | 8254 One Calais Ave, Suite 100, Baton Rouge, LA 70809-3450 | 2006-09-23 |
| Street Address |
3550 SE WOODWARD ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295899649 | Jamie Vandergon | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2006-12-20 |
| 1235426404 | Colleen Michelle Conklin | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-07-07 |
| 1669766689 | Seth C Cordell | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-06-07 |
| 1366735326 | Megan Ann Andersen | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-05-24 |
| 1134410046 | Cindy L Petersen | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-04-26 |
| 1265723191 | Christopher Laurence Anderson | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-04-26 |
| 1588962732 | Ivana Micanovic | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-03-11 |
| 1457659781 | Christopher Pate | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-03-10 |
| 1518265933 | Jay N Cacka | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2011-03-09 |
| 1740582295 | Jennifer Joy Loop | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2010-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143442 | Carewell LLC | Counselor | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
| 1588226765 | Melissa Lynn Hartley | Counselor | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
| 1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
| 1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
| 1134644321 | Bridgette Hennigsen | Social Worker | 3810 Se 11th Ave, Portland, OR 97202 | 2017-08-08 |
| 1558895789 | Lenore Cangeloso | Acupuncturist | 1235 Se Division Street, Suie 117, Portland, OR 97202 | 2017-04-14 |
| 1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
| 1144684663 | Catholic Charities | Case Management | 2740 Se Powell Blvd., Portland, OR 97202 | 2016-04-11 |
| 1881082097 | Zoomcare Dental, P.C. | Dentist | 3130 Se Division Street, Building 2, Portland, OR 97202 | 2014-12-23 |
| 1124424700 | Jessica Nash | Counselor | 6411 Se 17th Ave, Portland, OR 97202 | 2014-11-10 |
| Find all providers in zip 97202 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427160 | Kristine Lee Jones | Counselor | 2628 Se 87th Ave, Portland, OR 97266-1530 | 2020-11-05 |
| 1932711322 | Rachel Wilson | Counselor | 1020 Se 7th Ave # 14283, Portland, OR 97214-2387 | 2020-08-18 |
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1972124196 | Outside In | Counselor | 16144 E Burnside St, Portland, OR 97233-3520 | 2020-04-28 |
| 1962022350 | Nicole Blake | Counselor | 400 Commercial St, Portland, ME 04101-4660 | 2020-04-25 |
| 1912527201 | Alexa Jenkins | Counselor | 2700 Se Stark St Apt 3, Portland, OR 97214-3499 | 2020-04-16 |
| 1467086629 | Katelan Ruby Hostetler | Counselor | 13300 Ne San Rafael St, Portland, OR 97230-3123 | 2020-02-26 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1093346777 | Sprout Therapy Pdx LLC | Counselor | 7704 N Hereford Ave, Portland, OR 97203-3434 | 2020-01-30 |
| 1861030553 | Steve Bijoga | Counselor | 1350 Forest Ave Apt 16, Portland, ME 04103-1815 | 2019-12-13 |
| 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.