JACQUELINE FERNANDEZ ADLAWAN – Family Medicine Physician, NPI 1598708125
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,083 FAMILY PRACTICE in OR
Provider Addresses for JACQUELINE FERNANDEZ ADLAWAN
2850 SE Powell Valley Rd
Gresham, OR 97080
Phone: (503) 666-5050
Type: Location
98-1005 Moanalua Road
Suite 3030
Aiea, HI 967014735
Phone: (808) 627-3255
Fax: (808) 627-3265
Type: Location
Kuahelani Avenue, Mililani, Honolulu County, Hawaii, 96789, United States
MILILANI, HI 967891192
Phone: (808) 627-3255
Fax: (808) 627-3265
Type: Mailing
Uncle’s Fish Market & Grill, 98-1005, Moanalua Road, Waimalu, Aiea, Honolulu County, Hawaii, 96701, United States
SUITE 3030
AIEA, HI 967014735
Phone: (808) 627-3255
Fax: (808) 627-3265
Type: Location
500 NE MULTNOMAH ST FL 11
PORTLAND, OR 972322023
Phone:
Type: Mailing
9800 SE SUNNYSIDE RD
CLACKAMAS, OR 970159750
Phone: (800) 813-2000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-09-04 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $14 |
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: 2022-11-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20061129000351 | I | Nurse Practitioner | WA | TBD |
| I20100609000074 | I | Nurse Practitioner | OR | TBD |
| I20221109001501 | I | Family Practice | OR | 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 97080)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | TX | |
| Emergency Medicine | OR | |
| D E R M A T O L O G Y | AZ | |
| Nurse Practitioner | OR | |
| Diagnostic Radiology | OR | |
| D E R M A T O L O G Y | WA | |
| - | OR | |
| - | CA | |
| General Surgery | CA | |
| - | OR |
Reviews
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