Jonathan Dominguez, LCSW in Tigard, OR - Medicare Counselor Provider

Jonathan Dominguez, LCSW is a medicare enrolled "Counselor - Mental Health" provider in Tigard, Oregon. His current practice location is 11740 Sw 68th Pkwy Ste 200, Tigard, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 597-8393.

Jonathan Dominguez is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487279923.

Contact Information

	Jonathan Dominguez, LCSW
	11740 Sw 68th Pkwy Ste 200, Tigard, OR 97223-9058
	(503) 597-8393
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jonathan Dominguez
Gender	Male
Speciality	Counselor - Mental Health
Location	11740 Sw 68th Pkwy Ste 200, Tigard, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487279923
Provider Enumeration Date: 06/10/2020
Last Update Date: 09/01/2023

Medicare PECOS Information:

PECOS PAC ID: 1951843259
Enrollment ID: I20240601000333

Medical Identifiers

Medical identifiers for Jonathan Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487279923	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Dominguez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jonathan Dominguez, LCSW 475 W Gloucester St, Gladstone, OR 97027-2059 Ph: (406) 529-8100	Jonathan Dominguez, LCSW 11740 Sw 68th Pkwy Ste 200, Tigard, OR 97223-9058 Ph: (503) 597-8393

Reviews and Comments

Counselor in Tigard, OR

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Corbin Gronvold, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3740

Jonathan Dominguez, LCSW - Medicare Counselor in Tigard, OR