MEDICARE: JACQUELINE ELIZABETH GOMEZ LCSW

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
1	1041C0700X	Clinical Social Worker	LW60770104	WA
2	1041C0700X	Clinical Social Worker	L7655	OR

General Provider Information

NPI Number	:	1669812210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE ELIZABETH GOMEZ LCSW

Provider Business Mailing Address
First Line	:	1918 NE 143RD AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-4101
Country	:	US
Telephone Number	:	503-726-9630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1918 NE 143RD AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-4101
Country	:	US
Telephone Number	:	503-726-9630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2013
Last Update Date	:	01/27/2020

Similar Medicare Providers

1801890546 — LINDA MARIE PETERSON CRNA
Practice Location Address:

202 SANDPIPER DR
PORTLAND, TX
78374-4101

Practice Phone: 361-777-0282
Practice Fax:

1992787410 — EYE HEALTH NORTHWEST OPTICAL, LLC
Practice Location Address:

15405 SW 116TH AVE , SUITE 204
PORTLAND, OR
97224-4101

Practice Phone: 503-620-4070
Practice Fax: 503-598-9661

1144466152 — CLAIRE OPPENHEIM LLC
Practice Location Address:

75 PEARL ST , SUITE 410
PORTLAND, ME
04101-4101

Practice Phone: 207-773-0050
Practice Fax: 207-828-1489

1376963959 — LEENA YOUSSEFIAN MD
Practice Location Address:

4101 SW HILLSDALE AVE
PORTLAND, OR
97239-1547

Practice Phone: 570-271-6144
Practice Fax:

1194279802 — LINDSAY PAYEUR
Practice Location Address:

75 PEARL ST , SUITE 470 (E)
PORTLAND, ME
04101-4101

Practice Phone: 818-345-2345
Practice Fax: 818-758-8015

1689322273 — KATHERINE MARIE RAHMANIAN HOSSEINABADI
Practice Location Address:

2515 NW 81ST PL
PORTLAND, OR
97229-4101

Practice Phone: 503-319-2165
Practice Fax:

Directions to “ JACQUELINE ELIZABETH GOMEZ LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.