MS. JENNIFER INDIGO (NPI# 1184084519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184084519 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER INDIGO |
| Credential | AS |
| Practice Address |
182 Sw Academy St Dallas OR 97338-1996 |
| Practice Telephone | 5036239289 |
| Mailing Telephone | 5036239289 |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OR | Other Service Providers |
| Street Address |
182 SW ACADEMY ST |
| City | DALLAS |
| State | OR |
| Zip Code | 97338-1996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841308632 | Alfredo Jose Soto | Psychiatry & Neurology | 182 Sw Academy St, Suite 30, Dallas, OR 97338-1922 | 2006-08-29 |
| 1528669918 | Helen Canchola Martinez | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-11-03 |
| 1013525542 | Zachary Beeler | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-07-21 |
| 1376175398 | Theresa Ann Kollars | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-02-07 |
| 1346883071 | Heather Grandis | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-25 |
| 1154963320 | Tori A Geter | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-09 |
| 1801437231 | Maria Ross | Student in an Organized Health Care Education/Training Program | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-07 |
| 1144871096 | Kayli Peterson | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-09-23 |
| 1174170187 | Mikel-anne Devine | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-08-23 |
| 1699320440 | Kelli Diane Bennett | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932042 | Stephanie Marie Renfro | Massage Therapist | 289 E Ellendale Ave #601, Dallas, OR 97338 | 2017-10-05 |
| 1588185953 | Herbert Starr Woodward IIi | Dentist | 201 Se Washington St, Dallas, OR 97338 | 2017-07-06 |
| 1851708077 | David Mooso | Pharmacist | 321 Nw Kings Valley Highway, Dallas, OR 97338 | 2014-07-21 |
| 1841615556 | Leslie Lytle | Counselor | 1020 Sw Maple St., Dallas, OR 97338 | 2014-03-04 |
| 1205265493 | Chung-fan Ni | Counselor | 182 S. W. Academy St., Academy Building, Dallas, OR 97338 | 2013-11-07 |
| 1215204300 | Ron Fritz | Counselor | 239 E. Ellendale, Suite 602, Dallas, OR 97338 | 2011-11-17 |
| 1235420167 | Deborah Kennedy | Counselor | 527 Ne Fern Ave, Dallas, OR 97338 | 2011-04-26 |
| 1821229774 | Chelsea Ruhoff Lee | Physician Assistant | 1000 Se Uglow Avenue, Flaming Medical Center, Dallas, OR 97338 | 2009-07-27 |
| 1013128560 | Larry J Vuylsteke | Social Worker | 182 S.w. Academy, Dallas, OR 97338 | 2007-05-25 |
| 1093926123 | Justin W Reed | Counselor | Academy Building, 182 S.w. Academy St. Suite 304, Dallas, OR 97338 | 2007-05-24 |
| Find all providers in zip 97338 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659850519 | Susan Elaine Arthurs | Peer Specialist | 745 Sw Robinhood Dr, Dallas, OR 97338-1839 | 2018-08-11 |
| 1245608629 | John Blanchard | Peer Specialist | 18805 Oakdale Rd, Dallas, OR 97338-9649 | 2015-09-02 |
| 1477949832 | Jennifer Pangburn | Peer Specialist | 277 Sw Walnut Ave Apt 17, Dallas, OR 97338-5102 | 2015-04-13 |
| 1295146017 | Allison Highsmith | Peer Specialist | 182 Sw Academy St, Dallas, OR 97338-1996 | 2014-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
| 1962000554 | Dawn Marks | Peer Specialist | 21440 Se Stark St, Gresham, OR 97030-2024 | 2020-10-15 |
| 1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1982237236 | Jessica M Montoya | Peer Specialist | 235 Se Knowledge St, Prineville, OR 97754-2362 | 2020-02-14 |
| 1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
| 1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
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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.