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Jolynn Denise Shaffer , CRM II, QMHA-R

Counselor - Addiction (Substance Use Disorder) β€’ Gresham, OR

Active NPI 1467123596 Individual Practitioner Female Practitioner
Practice location in NPPES

355 Nw Division St
Gresham, OR 970305523

Call 9712256695 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

355 Nw Division St

Gresham, OR 970305523

Telephone 9712256695
Fax 5032311654
Organization at the Same NPPES Address or Phone
Native American Rehabilitation Assoc Inc Facility NPI 1558112276

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gresham and Oregon

81 active clinicians are listed under Counselor - Addiction (Substance Use Disorder) with a practice address in Gresham, OR (4,040 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gresham

0% of these 81 clinicians have the CMS telehealth indicator.

0% of these 81 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-11-05
Counselor - Addiction (Substance Use Disorder) Primary Specialty

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OR 25-CRM-II-0495
Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES OR 25-QMHA-R-7149
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
500812661 (OR)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ‘€
Provider Name / Credentials Updated November 05, 2025

Recorded as JOLYNN SHAFFER, CRM II/QMHA-R

πŸ“
Updated Practice Location September 17, 2025

Registered at 355 NW DIVISION ST, GRESHAM, OR 970305523 (Tel: 9712256695)

πŸ“
Updated Business Mailing Address September 17, 2025

Registered at 211 SE CARUTHERS ST, PORTLAND, OR 972144502 (Tel: 5032241044)

πŸ‘€
Provider Name / Credentials Updated September 17, 2025

Recorded as JOLYNN SHAFFER, CRM/QMHA-R

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2025

Counselor (license number reported to NPPES: OR 25-QMHA-R-7149)

πŸ“
Updated Practice Location July 26, 2022

Registered at 1631 SW COLUMBIA ST, PORTLAND, OR 972016025 (Tel: 5032312641)

πŸ“
Updated Business Mailing Address July 26, 2022

Registered at 1776 SW MADISON ST, PORTLAND, OR 972051715 (Tel: 5032241044)

πŸ‘€
Provider Name / Credentials Updated July 26, 2022

Recorded as JOLYNN SHAFFER, CRM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2022

Counselor (license number reported to NPPES: OR 21-CRM-780)

βœ…
NPI Profile Active September 28, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 28, 2021

Registered at 7916 SE FOSTER RD STE 201, PORTLAND, OR 972064289 (Tel: 5032908850)

πŸ“
Business Mailing Address (Initial Record) September 28, 2021

Registered at PO BOX 16576, PORTLAND, OR 972920576

πŸ‘€
Provider Name / Credentials (Initial Record) September 28, 2021

Recorded as JOLYNN SHAFFER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2021

Peer Specialist

🟒
Initial NPI Registration & Enumeration September 28, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1467123596
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 28, 2021
Last Update: November 05, 2025
Sole Proprietor: No

Mailing Address

211 Se Caruthers St

Portland, OR 972144502

Phone: 5032241044

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.