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

JASON MATTHEW NICHOLS
NPI 1104690031
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR

Active since November 10, 2023
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202(503) 744-7186 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 12, 2026, Nov 10, 2023 (2 updates tracked since 2023).

About Jason Matthew Nichols NPPES

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

JASON MATTHEW NICHOLS (NPI 1104690031) is an individual psychiatric/mental health provider in Portland, Oregon, licensed in Oregon (10065379) and active in the NPI registry since November 2023.

NPPES Registry Identity

NPI1104690031
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameJASON MATTHEW NICHOLS
Location Address205 SE SPOKANE ST STE 300Portland, OR 97202-6487
Mailing Address205 Se Spokane St Ste 300Portland, OR 97202-6487 · (503) 494-7725
Phone(503) 744-7186
Sole ProprietorNo
Enumeration DateNovember 10, 2023
Last NPPES UpdateAugust 12, 20262 updates tracked since enumeration
NPPES CertifiedAugust 12, 2026
✔ NPI 1104690031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in OR · 10065379
205 SE SPOKANE ST STE 300, Portland, OR 97202
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI STACHELRODT LMT
Massage Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 866-9271
CULTIVATING A NEW LIFE LLC
Social Worker (Clinical)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (541) 904-0468
NATHAN DAVIS LICENSED MARRIAGE &
Marriage & Family Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (971) 777-8929
MOONLIGHT THERAPIES LLC
Massage Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (971) 772-8322
DR. MAYA M WILLIAMS PHD
Psychologist (Counseling)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 877-0711
FUMIYO NISHIMOTO LCSW
Social Worker (Clinical)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (541) 904-0468
DR. JULIA ANN WONG-NGAN PH.D.
Clinical Neuropsychologist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 242-0490
KAYLEE SHIELDS BCBA
Behavior Analyst
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 473-1876

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 Jason Nichols's NPI number?

The NPI number for Jason Nichols is 1104690031. It was assigned to this individual provider in the NPPES registry on November 10, 2023.

Where is Jason Nichols located?

Jason Nichols practices at 205 SE Spokane St Ste 300, Portland, OR 97202. The listed phone number is (503) 744-7186.

What is Jason Nichols's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Jason Nichols was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.