DR. JESSICA ELLEN WILSON (NPI# 1841675709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841675709 |
| Entity Type | Individual |
| Full Name | DR. JESSICA ELLEN WILSON |
| Credential | M.S., PSY.D. |
| Practice Address |
4004 Se Woodstock Blvd Portland OR 97202-7662 |
| Mailing Address |
10115 Se Bell Ave Milwaukie OR 97222-2533 |
| Practice Telephone | 5037770444 |
| Practice Fax Number | 5037770445 |
| Mailing Telephone | 7025401819 |
| Mailing Fax Number | 5307770445 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-11-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2617 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467068411 | Jessica Lauren Wilson | Nutritionist | 1925 Brady Ave, Arbutus, MD 21227-4109 | 2020-09-16 |
| 1235754086 | Jessica Vienna Wilson | Massage Therapist | 13 Radnor Ave Fl 2, Croton On Hudson, NY 10520-2621 | 2020-06-08 |
| 1831749654 | Jessica Keely Wilson | Licensed Vocational Nurse | 3356 County Road 313, Dublin, TX 76446-6631 | 2019-09-13 |
| 1629622162 | Jessica Patreece Wilson | Nurse Practitioner | 7303 Brittney Lane, Kenly, NC 27542 | 2019-08-01 |
| 1346808623 | Jessica Wilson | Behavior Technician | 415 N Richard Jackson Blvd Ste 209, Panama City Beach, FL 32407-3694 | 2019-06-03 |
| 1336640820 | Jessica Wilson | Registered Nurse | 25 Connecticut Ave, Midlothian, TX 76065-6747 | 2018-02-21 |
| 1427566934 | Jessica N Wilson | Behavior Technician | 12125 Day St Ste E301, Moreno Valley, CA 92557-6704 | 2018-01-18 |
| 1912447616 | Jessica Wilson | Nurse Practitioner | 740 S Limestone J401, Lexington, KY 40536-0001 | 2017-02-28 |
| 1215387253 | Jessica Evelynne Wilson | Speech-Language Pathologist | 210 Spring Creek Ave Apt A, Bowling Green, KY 42101-5478 | 2016-06-21 |
| 1295101061 | Jessica Elaine Wilson | Marriage & Family Therapist | 983 Norumbega Dr, Monrovia, CA 91016-1826 | 2015-08-17 |
| Street Address |
4004 SE WOODSTOCK BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-7662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003978164 | Jennifer Gamache Kearns | Acupuncturist | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2006-12-15 |
| 1700351962 | Kailashi Zigler | Acupuncturist | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2018-10-03 |
| 1477042190 | Jana K Zahler | Massage Therapist | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2018-05-08 |
| 1922595826 | Nicole Craigmiles | Massage Therapist | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2018-04-16 |
| 1952829442 | Chelsea Leigh Desorbo | Lactation Consultant, Non-RN | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2017-09-05 |
| 1831612381 | Lara Greenberg | Clinic/Center | 4004 Se Woodstock Blvd, Bliss Lactation, Portland, OR 97202 | 2017-07-17 |
| 1962935312 | Mitch Bacon LLC | Marriage & Family Therapist | 4004 Se Woodstock Blvd, #9, Portland, OR 97202-7662 | 2017-04-04 |
| 1326593971 | Bliss Lactation, LLC | Clinic/Center | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2016-08-23 |
| 1265885750 | Jessica Budjac | Chiropractor | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2016-07-20 |
| 1609285154 | Jennifer Leigh Farrington | Massage Therapist | 4004 Se Woodstock Blvd, Portland, OR 97202-7662 | 2014-08-08 |
| 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 | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| 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.