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NPI Code Detail

MEDICARE: JANESSA JAVEL THOMAS

MEDICARE: JANESSA JAVEL THOMAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator253J00000XOR

General Provider Information

NPI Number : 1881354926
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANESSA JAVEL THOMAS
Provider Business Mailing Address
First Line : 5316 E BURNSIDE ST APT 9
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1279
Country : US
Telephone Number : 971-258-0337
Fax Number :
Provider Business Practice Location Address
First Line : 121 E HISTORIC COLUMBIA RIVER HWY
Second Line :
City : TROUTDALE
State : OR
Zip : 97060-2006
Country : US
Telephone Number : 971-293-9237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2021
Last Update Date : 02/04/2026

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Directions to “ JANESSA JAVEL THOMAS ” Practice Location

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