MR. JES RYAN BRADSHAW MA
NPI 1518315829
Counselor - Mental Health in Portland, OR

Q: What is Jes Bradshaw's NPI number?

The NPI number for Jes Bradshaw is 1518315829. It was assigned to this individual provider in the NPPES registry on May 26, 2016.

Q: What is Jes Bradshaw's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Jes Bradshaw enrolled in Medicare?

No. Jes Bradshaw has opted out of Medicare through March 11, 2027. 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 Jes Bradshaw was last updated on June 28, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 26, 2016Opted out of Medicare · through Mar 11, 2027

2923 NE BROADWAY ST, PORTLAND, OR 97232(503) 941-0856 Get Directions Write a Review

NPPES record last updated: June 28, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Jes Ryan Bradshaw Ma NPPES

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

MR. JES RYAN BRADSHAW MA (NPI 1518315829) is an individual mental health provider in Portland, Oregon and active in the NPI registry since May 2016. He has opted out of Medicare through March 11, 2027.

NPPES Registry Identity

NPI1518315829

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. JES RYAN BRADSHAWCredential: MA

Location Address2923 NE BROADWAY STPortland, OR 97232-1760

Mailing Address2923 Ne Broadway StPortland, OR 97232-1760 · (503) 941-0856

Phone(503) 941-0856

Sole ProprietorNo

Enumeration DateMay 26, 2016

Last NPPES UpdateJune 28, 2019

✔ NPI 1518315829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

2923 NE BROADWAY ST, Portland, OR 97232

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Jes Ryan Bradshaw Ma 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 March 11, 2025 through March 11, 2027.

Opt-Out Effective DateMarch 11, 2025

Opt-Out In Effect ThroughMarch 11, 2027Opt-out affidavits renew automatically every two years unless cancelled

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.

ALISSA GODDARD

Counselor (Mental Health)