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JUSTIN ERIC PRONOVOST
NPI 1326933284
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since June 11, 2025
2730 S MOODY AVE, PORTLAND, OR 97201(858) 216-5080(858) 216-5080 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Justin Eric Pronovost NPPES

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

JUSTIN ERIC PRONOVOST (NPI 1326933284) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1326933284
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUSTIN ERIC PRONOVOST
Location Address2730 S MOODY AVEPortland, OR 97201-5042
Mailing Address2730 S Moody AvePortland, OR 97201-5042 · (503) 494-3633
Phone(858) 216-5080
Fax(858) 216-5080
Sole ProprietorNo
Enumeration DateJune 11, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1326933284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2730 S MOODY AVE, Portland, OR 97201
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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.

DR. ESHA MUKHERJEE MSD
Dentist (Prosthodontics)
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (502) 531-3763
DANIEL SCOTT KOSKENMAKI
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-8428
SARHA ELENA RUSS
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-3633
MARK PUSUNG
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-8428
KATHERINE KELLY FOSSETTA PHYSICIAN ASSISTANT
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-9645
LAT WIN
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-3633
LAUREN THOMPSON
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-8311
KAYLA MARIE RORVIG
Student in an Organized Health Care Education/Training Program
2730 S MOODY AVE
PORTLAND, OR 97201
Multnomah County (503) 494-3633

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 Justin Pronovost's NPI number?

The NPI number for Justin Pronovost is 1326933284. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Justin Pronovost located?

Justin Pronovost practices at 2730 S Moody Ave, Portland, OR 97201. The listed phone number is (858) 216-5080.

What is Justin Pronovost's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Justin Pronovost was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.