Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JEREMY MCALLISTER MA, LPC
NPI 1063719417
Counselor - Professional in Portland, OR

Q: What is Jeremy Mcallister's NPI number?

The NPI number for Jeremy Mcallister is 1063719417. It was assigned to this individual provider in the NPPES registry on February 22, 2011. The provider is also known as Jeremy Mcallister Ma, Lpc.

Q: What is Jeremy Mcallister's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: Is Jeremy Mcallister enrolled in Medicare?

No. Jeremy Mcallister has opted out of Medicare through January 4, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Mcallister was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 22, 2011Opted out of Medicare · through Jan 4, 2028

4230 SE KING RD UNIT 374, PORTLAND, OR 97222(503) 284-6754(503) 284-6754 Get Directions Write a Review

NPPES record last updated: October 26, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 26, 2026, Dec 9, 2025, Oct 1, 2015 (3 updates tracked since 2015).

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About Jeremy Mcallister Ma, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY MCALLISTER MA, LPC (NPI 1063719417) is an individual professional provider in Portland, Oregon, licensed in Oregon (C3882) and active in the NPI registry since February 2011. He has opted out of Medicare through January 4, 2028.

NPPES Registry Identity

NPI1063719417

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameJEREMY MCALLISTERCredential: MA, LPC

Location Address4230 SE KING RD UNIT 374Portland, OR 97222-5259

Mailing Address4230 Se King Rd Unit 374Portland, OR 97222-5259 · (503) 284-6754 · Fax (503) 284-6754

Phone(503) 284-6754

Fax(503) 284-6754

Sole ProprietorYes

Enumeration DateFebruary 22, 2011

Last NPPES UpdateOctober 26, 20263 updates tracked since enumeration

NPPES CertifiedOctober 26, 2026

✔ NPI 1063719417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in OR · C3882✔ Licensed in WA · LH70148074

4230 SE KING RD UNIT 374, Portland, OR 97222

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Other Names 1

Professional Name (2)Jeremy Mcallister Ma, Lpc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jeremy Mcallister Ma, Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 4, 2026 through January 4, 2028.

Opt-Out Effective DateJanuary 4, 2026

Opt-Out In Effect ThroughJanuary 4, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremy Mcallister's NPI number?

The NPI number for Jeremy Mcallister is 1063719417. It was assigned to this individual provider in the NPPES registry on February 22, 2011. The provider is also known as Jeremy Mcallister Ma, Lpc.

Where is Jeremy Mcallister located?

Jeremy Mcallister practices at 4230 SE King Rd Unit 374, Portland, OR 97222. The listed phone number is (503) 284-6754.

What is Jeremy Mcallister's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jeremy Mcallister enrolled in Medicare?

No. Jeremy Mcallister has opted out of Medicare through January 4, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jeremy Mcallister was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.