JENCINA M BUTLER DO NPI 1295823847

NPI Information

NPI: 1295823847
Provider Name: JENCINA M BUTLER, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
12518 NE AIRPORT WAY STE 110
PORTLAND, OR
ZIP 97230
Phone: (503) 256-2992
Get Directions

Jencina M Butler, DO is a family medicine in Portland, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jencina M Butler, DO NPI is 1295823847. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12518 NE AIRPORT WAY STE 110
PORTLAND, OR
ZIP 97230-090
Phone: (503) 256-2992
Fax: (503) 258-0717

The NPI 1295823847 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 11/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		OP00002071	WASHINGTON	No
2	207Q00000X	Family Medicine		DO24488	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I25103	MEDICARE UPIN	WASHINGTON
2	11959880	MEDICARE UPIN	OREGON
3	210973	OTHER		DEPT OF LABOR & INDUST
4	G8859148	MEDICAID	OREGON
5	G8859148	MEDICARE PIN	WASHINGTON
6	R150420	MEDICARE PIN	OREGON
7	8449662	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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