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JESSE C STAUBACH
NPI 1114560802
Peer Specialist in Coos Bay, OR

Active since October 24, 2019
320 CENTRAL AVE STE 304, COOS BAY, OR 97420(541) 366-7640 Get Directions Write a Review

NPPES record last updated: October 24, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jesse C Staubach NPPES

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

JESSE C STAUBACH (NPI 1114560802) is an individual peer specialist in Coos Bay, Oregon, licensed in Oregon (THW000003807) and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1114560802
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameJESSE C STAUBACH
Location Address320 CENTRAL AVE STE 304Coos Bay, OR 97420-2241
Mailing AddressPo Box 802Coos Bay, OR 97420-0148 · (541) 295-9240
Phone(541) 366-7640
Sole ProprietorNo
Enumeration DateOctober 24, 2019
✔ NPI 1114560802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · THW000003807
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
320 CENTRAL AVE STE 304, Coos Bay, OR 97420
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Other Providers at the Same Location NPPES 5

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

PACIFIC COAST PRIMARY CARE
Nurse Practitioner (Family)
320 CENTRAL AVE STE 304
COOS BAY, OR 97420
Coos County (720) 427-5713
LESLIE JO LINTNER CPSS
Counselor (Professional)
320 CENTRAL AVE STE 304
COOS BAY, OR 97420
Coos County (541) 336-7640
FELISHA MILLER FNP
Nurse Practitioner (Family)
320 CENTRAL AVE STE 304
COOS BAY, OR 97420
Coos County (541) 269-0800
DEBORAH B MANDERS L.AC.
Acupuncturist
320 CENTRAL AVE STE 304
COOS BAY, OR 97420
Coos County (541) 266-7694
NICOLE CASTHELY MSW
Social Worker (Clinical)
320 CENTRAL AVE STE 304
COOS BAY, OR 97420
Coos County (541) 257-5778

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 Jesse Staubach's NPI number?

The NPI number for Jesse Staubach is 1114560802. It was assigned to this individual provider in the NPPES registry on October 24, 2019.

Where is Jesse Staubach located?

Jesse Staubach practices at 320 Central Ave Ste 304, Coos Bay, OR 97420. The listed phone number is (541) 366-7640.

What is Jesse Staubach's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Jesse Staubach was last updated on October 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.