Provider Demographics
NPI:1629620497
Name:MAY, JONATHAN WAYNE (PMHNP)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:WAYNE
Last Name:MAY
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11575 SW PACIFIC HWY # 3020
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8671
Mailing Address - Country:US
Mailing Address - Phone:503-461-8022
Mailing Address - Fax:503-836-9436
Practice Address - Street 1:10260 SW GREENBURG RD FL 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5500
Practice Address - Country:US
Practice Address - Phone:503-461-8022
Practice Address - Fax:503-836-9436
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR202113375NP-PP363LP0808X
CA1629620497363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health