DANIELLE ASHLEY JACKSON (NPI# 1669093431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669093431 |
| Entity Type | Individual |
| Full Name | DANIELLE ASHLEY JACKSON |
| Practice Address |
2730 Sw Moody Ave Portland OR 97201-5042 |
| Practice Telephone | 5034943633 |
| Practice Fax Number | 5034941409 |
| Mailing Telephone | 5034943633 |
| Mailing Fax Number | 5034941409 |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2020-05-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112179 | Danielle Caitlin Jackson | Physician Assistant | 1011 Harlan St, Indianapolis, IN 46203-1318 | 2020-04-07 |
| 1295215226 | Danielle Jackson | Student in an Organized Health Care Education/Training Program | 7427 Meadow Run Ct, Mobile, AL 36619-3632 | 2018-08-20 |
| 1578914537 | Danielle Jackson | Case Manager/Care Coordinator | 2088 Carver Dr, Marrero, LA 70072 | 2016-06-30 |
| 1063879930 | Danielle Marie Jackson | Licensed Practical Nurse | 4 Hawk Nest Ln Apt 2, Wallkill, NY 12589-2630 | 2016-01-24 |
| 1033585831 | Danielle Lawanna Jackson | Registered Nurse | 213 Birkdale Dr, Daytona Beach, FL 32124-2053 | 2015-08-15 |
| 1578906905 | Danielle S Jackson | Psychiatry & Neurology | 446 E Ontario St Ste 200, Chicago, IL 60611-4418 | 2013-04-16 |
| 1033419155 | Danielle Jackson | Physician Assistant | 1845 Satellite Blvd Nw, Duluth, GA 30097-5256 | 2010-10-22 |
| 1841818531 | Danielle Beverly Jackson | Speech-Language Pathologist | 4501 Jackson Rd, Fredericksburg, VA 22407-6706 | 2020-07-08 |
| 1104461730 | Danielle Jackson | Pharmacist | 6181 Us Highway 431, Albertville, AL 35950-2011 | 2019-11-06 |
| 1518436559 | Danielle Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2018-11-20 |
| Street Address |
2730 SW MOODY AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97201-5042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206313 | Kerrie Lee Shirley | Pharmacist | 2730 Sw Moody Ave, Pmb 260, Portland, OR 97201 | 2005-06-21 |
| 1154943116 | Yves Gacinya | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-13 |
| 1427670660 | Claudemir Da Silva Lima | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-11 |
| 1639791726 | An Ruan | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-11 |
| 1437771904 | Lucia Novak | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-07 |
| 1881215358 | Donald Alfred Defrang II | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-06 |
| 1992326573 | Mirah-aizza Galuego | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-05 |
| 1063033819 | Kelsey Moore | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-04 |
| 1164043972 | Andrew Henderson | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-04 |
| 1225659006 | Thomas Peckenham-hernandez | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206060 | Laura Elizabeth Jackson | Student in an Organized Health Care Education/Training Program | 2730 S Moody Ave, Portland, OR 97201 | 2020-05-10 |
| 1225659063 | Amanpreet Kaur | Student in an Organized Health Care Education/Training Program | Ohsu Physician Assistant Program, 2730 South Moody Ave. Mail Code: Cl5pa, Portland, OR 97201 | 2020-05-04 |
| 1063033801 | Aaron Kinn | Student in an Organized Health Care Education/Training Program | Ohsu Division of Physician Assistant Education - Cl5pa, 2730 Sw Moody Avenue, Portland, OR 97201 | 2020-05-04 |
| 1487275442 | Erin Aleen Ostlie-madden | Student in an Organized Health Care Education/Training Program | 2730 South Moody Ave, Portland, OR 97201 | 2020-04-30 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1780172619 | Susan Elizabeth Christian Barrios | Social Worker | 1505 Sw College St, Portland, OR 97201 | 2018-04-26 |
| 1730696576 | Fiona Everett | Counselor | 1703 Sw Clay St, Portland, OR 97201 | 2018-01-02 |
| 1437678844 | Akira Thomas Neilsen | Student in an Organized Health Care Education/Training Program | 1930 Sw River Drive, Unit 102, Portland, OR 97201 | 2017-09-18 |
| 1285171736 | Howard Mitchell | Technician, Other | 1110 Sw Clay Street Apt. 34, Portland, OR 97201 | 2017-01-23 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
| 1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
| 1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
| 1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
| 1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
| 1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
| 1669081659 | Amy Hill | Student in an Organized Health Care Education/Training Program | 3931 N Juneau St Apt 7, Portland, OR 97217-7419 | 2020-07-27 |
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1558986364 | Haley Bosco Doyle | Student in an Organized Health Care Education/Training Program | 3587 Se Grant St, Portland, OR 97214-5829 | 2020-06-08 |
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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.