JASON GOLDBERG (NPI# 1336747021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336747021 |
| Entity Type | Individual |
| Full Name | JASON GOLDBERG |
| Practice Address |
7916 Se Foster Rd Ste 201 Portland OR 97206-4289 |
| Mailing Address |
Po Box 16576 Portland OR 97292-0576 |
| Practice Telephone | 5034652749 |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | THW000003833 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447600119 | Jason Michael Goldberg | Dentist | 8815 Christenbury Pkwy Ste 40, Concord, NC 28027-0261 | 2016-06-14 |
| 1104138403 | Jason Lee Goldberg | Internal Medicine | 120 Radnor Rd Ste 100, State College, PA 16801 | 2010-07-02 |
| 1093161655 | Jason Goldberg | Ophthalmology | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2016-05-12 |
| 1194161646 | Jason Goldberg | Counselor | 153 Hazard Ave, Enfield, CT 06082-4592 | 2013-05-10 |
| 1255692067 | Jason Asher Goldberg | Pediatrics | 333 N Texas Ave, Suite 4300, Webster, TX 77598-4966 | 2012-06-07 |
| 1518261171 | Jason Frederick Goldberg | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2010-12-22 |
| 1427212851 | Jason Matthew Goldberg | Social Worker | 4401 East West Highway, Suite 207, Bethesda, MD 20814 | 2008-07-15 |
| 1073731790 | Jason Goldberg | Dentist | 1030 Saint Georges Ave, Avenel, NJ 07001-1390 | 2007-04-20 |
| Street Address |
7916 SE FOSTER RD STE 201 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97206-4289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326410986 | Bridges To Change | Community/Behavioral Health | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2015-10-22 |
| 1629679444 | Rebecca Klassy | Counselor | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-11-06 |
| 1841898467 | Jason Stutzman | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-10-15 |
| 1477150019 | Jesse Farr-baenziger | Counselor | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-10-07 |
| 1023625233 | Jeffrey Feldes | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-09-30 |
| 1396358933 | Rena Williams | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-08-24 |
| 1861003543 | Isaac Salazar | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-08-14 |
| 1093326977 | Allie Mendez | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-08-13 |
| 1649898719 | Denise Bare | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-07-06 |
| 1720606890 | Robert Boeckel | Peer Specialist | 7916 Se Foster Rd Ste 201, Portland, OR 97206-4289 | 2020-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
| 1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
| 1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
| 1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
| 1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
| 1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
| 1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
| 1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
| 1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
| 1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
| Find all providers in zip 97206 | ||||
| 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 |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on JASON GOLDBERG.
| 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.