DR. JILL KESSLER MCGOVERN (NPI# 1831318625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831318625 |
| Entity Type | Individual |
| Full Name | DR. JILL KESSLER MCGOVERN |
| Credential | PH.D. |
| Practice Address |
13831 Nw Cornell Rd Suite 103 Portland OR 97229-5485 |
| Practice Telephone | 5036452424 |
| Practice Fax Number | 5036433798 |
| Mailing Telephone | 5036452424 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
1505 | OR | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1505 | OR | Behavioral Health & Social Service Providers |
| X | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
1505 | OR | Behavioral Health & Social Service Providers |
| X | 103TS0200X |
Psychologist Specialization: School |
1505 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295360576 | Jill Kathleen Mcgovern | Physician Assistant | 106 Prospect Street, 3rd Floor, Ridgewood, NJ 07450-4433 | 2020-03-07 |
| Street Address |
13831 NW CORNELL RD SUITE 103 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-5485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255392502 | Faith E Winters | Counselor | 13831 Nw Cornell Rd, Suite 104, Portland, OR 97229-5485 | 2006-03-28 |
| 1952889735 | Viktoriya Krughkov | Dental Hygienist | 13831 Nw Cornell Rd, Portland, OR 97229-5485 | 2018-08-02 |
| 1275010514 | Andrea Elizabeth Lea Collins | Dentist | 13831 Nw Cornell Rd, Portland, OR 97229-5485 | 2018-07-19 |
| 1487167565 | Brian Gia Son Phan | Dentist | 13831 Nw Cornell Rd, Portland, OR 97229-5485 | 2017-11-10 |
| 1801271770 | Diane Henriot | Dentist | 13831 Nw Cornell Rd, Suite C, Portland, OR 97229-5485 | 2015-07-21 |
| 1679963433 | Anna Nguyen | Dentist | 13831 Nw Cornell Rd, Portland, OR 97229-5485 | 2015-02-02 |
| 1457667842 | Alexandra C. De Millo Terrazzani | Dentist | 13831 Nw Cornell Rd, Portland, OR 97229-5485 | 2010-08-24 |
| 1184879496 | Patricia Jane Cook | Marriage & Family Therapist | 13831 Nw Cornell Rd, Suite 104, Portland, OR 97229-2286 | 2008-12-01 |
| 1679727929 | Emilia C Adam | Dentist | 13831 Nw Cornell Rd, C, Portland, OR 97229-5485 | 2008-11-13 |
| 1255596904 | Debra Cox | Massage Therapist | 13831 Nw Cornell Rd, Suite 102, Portland, OR 97229-5485 | 2008-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740616325 | Kathleen Gregorich Hoffman | Psychologist | 3245 Nw Thurman St, Portland, OR 97210-1224 | 2013-09-16 |
| 1558708461 | Anthony Michael Duncan | Psychologist | 2236 Se Belmont St, Portland, OR 97214-2817 | 2013-05-31 |
| 1083998611 | Kaufman Psychological Services | Psychologist | 1321 Washington Ave Ste 102, Portland, ME 04103-3636 | 2011-09-30 |
| 1174813539 | Robert W Mclellarn, Phd | Psychologist | 5440 Sw Westgate Drive, Suite 175, Portland, OR 97221 | 2011-04-19 |
| 1346574449 | Jerusha Beth Detweiler-bedell | Psychologist | 5440 Sw Westgate Dr., #175, Portland, OR 97221-2436 | 2009-09-23 |
| 1386845048 | Morris Tiktin | Psychologist | 1201 Sw 12 Ave, Suite 300, Portland, OR 97205-2046 | 2007-05-30 |
| 1235341629 | Muriel D. Lezak | Psychologist | 2211 Sw 1st Ave, G10, Portland, OR 97201-5060 | 2007-05-05 |
| 1952528952 | Melisa L. Finch | Psychologist | 10201 Se Main St Ste 10, Portland, OR 97216-2937 | 2007-04-19 |
| 1992712103 | Maryann J Carroll | Psychologist | 25 Bedell St, Portland, ME 04103-1705 | 2006-08-01 |
| 1588642953 | Joseph Peter Gretsch | Psychologist | 818 Sw 3rd Ave, #148, Portland, OR 97204-2405 | 2006-01-05 |
| 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.