DR. PAMELA S JACOBS (PHD) – Psychologist, NPI 1366462418
Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
647 CLINICAL PSYCHOLOGIST in OR
Provider Addresses for DR. PAMELA S JACOBS (PHD)
1776 SW Madison St
Portland, OR 972051715
Phone: (503) 224-1044
Fax: (503) 621-2235
Type: Location
Native American Rehabilitation Association of the Northwest, 1776, Southwest Madison Street, Goose Hollow, Portland, Metro, Multnomah County, Oregon, 97205, United States
PORTLAND, OR 972051715
Phone: (503) 224-1044
Fax: (503) 621-2235
Type: Mailing
1776 SW MADISON ST
PORTLAND, OR 972051715
Phone: (503) 224-1044
Fax: (503) 621-2235
Type: Location
1616 CORNWALL AVE STE 205
BELLINGHAM, WA 982254642
Phone: (360) 676-6177
Fax: (360) 671-3574
Type: Location
NARA Indian Health Clinic, 15, North Morris Street, Albina, Eliot, Portland, Metro, Multnomah County, Oregon, 97227, United States
PORTLAND, OR 972271541
Phone: (503) 230-9875
Fax: (503) 230-9877
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-01-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230110001922 | I | Clinical Psychologist | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Clinical Social Worker | WA | |
| Mental Health Counselor | WA | |
| - | WY | |
| Mental Health Counselor | WA | |
| Clinical Social Worker | WA | |
| - | WA | |
| Nurse Practitioner | WA | |
| Physician Assistant | WA | |
| - | WA |
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