JOLENA MAE MALLORY (NPI# 1740778521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740778521 |
| Entity Type | Individual |
| Full Name | JOLENA MAE MALLORY |
| Credential | CRM |
| Practice Address |
7916 Se Foster Rd Portland OR 97206-4289 |
| Practice Telephone | 5039468745 |
| Mailing Telephone | 5039468745 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 17-CRM-213 | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 17-CRM-213 | 05 |
| Street Address |
7916 SE FOSTER RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97206-4289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
| 1275131633 | Brianne Morgan | Counselor | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2020-10-16 |
| 1720604911 | Larry Dean Beckner | Peer Specialist | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2020-06-23 |
| 1265058457 | Chris Lex | Peer Specialist | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2020-06-23 |
| 1508482787 | Aaron Bibens | Peer Specialist | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2020-06-23 |
| 1730705922 | Noelle Roehr | Peer Specialist | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2020-06-23 |
| 1821554056 | Audrey Mohonna Stanfield | Counselor | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2019-02-12 |
| 1932674157 | Meghan Leanne Maguire | Counselor | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2018-10-04 |
| 1447756515 | Catherine Elaine Van Valkenburgh | Counselor | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2018-04-05 |
| 1720530264 | Daniel Telgarsky | Peer Specialist | 7916 Se Foster Rd, Portland, OR 97206-4289 | 2016-11-01 |
| 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 |
| 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 |
| 1063774990 | Molly A Norris | Massage Therapist | 6217 Se Harold St, Portland, OR 97206 | 2012-06-15 |
| 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 | ||||
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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.