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Jake D Mathis
Peer Specialist in Newport, Oregon
NPI 1265173959

Jake D Mathis is a Peer Specialist based in Newport, OR. Jake D Mathis practices in Newport, OR. The NPI Number for Jake D Mathis is 1265173959 and holds a License No. 21-CRM-676 (Oregon).

The current practice location address for Jake D Mathis is 547 Sw 7Th St, Newport, OR and can be reached out via phone at 541-574-9570 and via fax at 541-574-8857.

Location: 547 Sw 7Th St, Newport, OR, 97365-0115
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265173959
Provider Name
Jake D Mathis
Credential
Provider Entity Type
Individual
Gender
Male
Address
547 Sw 7Th St, Newport, OR, 97365-0115
Phone Number
541-574-9570
Fax Number
541-574-8857
Provider Enumeration Date
04/05/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
547 Sw 7Th St
City
Newport
State
Oregon
Zip
97365-4909
Phone Number
541-574-9570
Fax Number
541-574-8857
person
Provider Business Mailing Address Details
Address
547 Sw 7Th St
City
Newport
State
Oregon
Zip
97365-4909
Phone Number
541-574-9570
Fax Number
541-574-8857
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
21-CRM-676 (Oregon)
Definition
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.
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