Judy Jackson (NPI# 1407569718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1407569718 |
| Entity Type | Individual |
| Full Name | Judy Jackson |
| Gender | Female |
| Practice Address |
745 Ne 122nd Ave Portland OR 97230-2001 |
| Practice Telephone | 5032520241 |
| Mailing Address |
745 Ne 122nd Ave Portland OR 97230-2001 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-01-02 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | 201408689LPN | OR |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255098869 | Judy Elaine Jackson | 604 W 11th St, Quanah, TX 79252-5412 | 2021-11-18 | |
| 1124601596 | Judy Jackson | 905 Roberts Cut Off Rd, River Oaks, TX 76114-2825 | 2021-05-03 | |
| 1396334660 | Judy L Jackson | 40326 State Route 681, Shade, OH 45776-9518 | 2021-01-12 | |
| 1851931026 | Judy Jackson | 206 Gatewood Ave, High Point, NC 27262-4820 | 2020-01-15 | |
| 1144860255 | Judy Jackson | 29 Morris Dr, Cumberland, VA 23040-2625 | 2020-01-07 | |
| 1255700571 | Judy Jackson | 2801 Buford Hwy Ne, Suite T30, Brookhaven, GA 30329-2149 | 2015-09-16 | |
| 1548671316 | Judy Marie Jackson | 5941 Wilerson Rd., Rex, GA 30273-1506 | 2014-05-15 | |
| 1235486473 | Judy Goldson Jackson | 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 | 2012-08-07 | |
| 1578847505 | Judy Ellen Jackson | 1950 N Okmulgee, Okmulgee, OK 74447-6534 | 2011-10-10 | |
| 1629205224 | Judy Jackson | 110 N Santa Cruz Ave, Suite C, Los Gatos, CA 95030-5919 | 2009-06-22 | |
| Find all providers with the same name | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265130538 | Arabella Zook | 2600 Se Belmont St, Portland, OR 972142916 | 2023-02-16 | |
| 1285349837 | Aretha L Johnson | 9750 Ne Glisan St, Portland, OR 972204449 | 2023-01-18 | |
| 1346953239 | Jennifer Redman | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2023-01-05 | |
| 1366154569 | Mallory King | 8643 Ne Beech St, Portland, OR 97220-5012 | 2022-12-19 | |
| 1851017990 | Rachel Graham | 324 Nw Davis St, Portland, OR 97209-3925 | 2022-10-19 | |
| 1477279735 | Jennelle Marie Lazaro | 2600 Se Belmont St, Portland, OR 97214-2916 | 2022-10-18 | |
| 1235855982 | Nathan Beach | 324 Nw Davis St, Portland, OR 97209-3925 | 2022-10-14 | |
| 1568187607 | David Aikins | 934 Congress St, Portland, ME 04102-3032 | 2022-10-11 | |
| 1306561501 | Sherry Triplett | 2600 Se Belmont St, Portland, OR 97214-2916 | 2022-10-10 | |
| 1881318673 | Danielle S Gonzalez | 934 Congress St, Portland, ME 04102-3032 | 2022-09-27 | |
| Find all providers in PORTLAND | ||||
| Street Address |
745 NE 122ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346953239 | Jennifer Redman | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2023-01-05 | |
| 1063135408 | Nicole J Kim | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2022-09-21 | |
| 1568183697 | Beverly Lynn Bruno | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2022-09-07 | |
| 1568183697 | Beverly Lynn Bruno | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2022-09-07 | |
| 1588333173 | Darlene Gayheart | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2021-09-08 | |
| 1780251561 | Lea Witter | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2021-06-09 | |
| 1144726225 | Ignacio Hidalgo | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2018-04-05 | |
| 1548634751 | Aaron R. Proctor | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2015-11-26 | |
| 1295178606 | Huckleberry Tm Koester | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2013-04-16 | |
| 1609124551 | Care Center (menlo Park) Inc. | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2012-08-27 | |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255031860 | Eberheardt Jay Wilson | 13942 Ne Glisan St, Portland, OR 972303350 | 2023-03-03 | |
| 1427755578 | Mary Elizabeth Taylor | 945 Ne 165th Ave, Portland, OR 972306148 | 2023-02-09 | |
| 1669186466 | Conor Edward Duffy | 1122 Ne 122nd Ave Ste A200, Portland, OR 97230-2083 | 2023-01-06 | |
| 1083326367 | Bridge of Hope Mental Health Services LLC | 13250 Ne Shaver St, Portland, OR 97230-1453 | 2022-12-19 | |
| 1881305076 | Alexander Noa Salamanca | 13942 Ne Glisan St, Portland, OR 97230-3350 | 2022-12-08 | |
| 1831800911 | Jaime Aguilar | 1122 Ne 122nd Ave Ste A200, Portland, OR 97230-2083 | 2022-12-08 | |
| 1316657067 | Mia Sigmund Gaines | 13942 Ne Glisan St, Portland, OR 97230-3350 | 2022-12-02 | |
| 1881302313 | Haylee Anne Deweese | 945 Ne 165th Ave, Portland, OR 97230-6148 | 2022-11-14 | |
| 1679281240 | Michael David Stentz | 945 Ne 165th Ave, Portland, OR 97230-6148 | 2022-11-11 | |
| 1649997909 | Nika Tate Sprite Erwin | 2100 Ne 137th Ave, Portland, OR 97230-4050 | 2022-10-26 | |
| Find all providers in zip 97230 | ||||
Please comment or provide details below to improve the information on Judy Jackson.
| 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.