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JACK KEENAN
NPI 1649641812
Counselor - Mental Health in Portland, OR

Active since October 14, 2015
3530 SE 136TH AVE APT 5, PORTLAND, OR 97236(503) 719-4535(503) 719-4537 Get Directions Write a Review

NPPES record last updated: February 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack Keenan NPPES

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

JACK KEENAN (NPI 1649641812) is an individual mental health provider in Portland, Oregon and active in the NPI registry since October 2015.

NPPES Registry Identity

NPI1649641812
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJACK KEENAN
Location Address3530 SE 136TH AVE APT 5Portland, OR 97236-2958
Mailing Address3587 Heathrow WayMedford, OR 97504-4004 · (347) 406-2922
Phone(503) 719-4535
Fax(503) 719-4537
Sole ProprietorNo
Enumeration DateOctober 14, 2015
Last NPPES UpdateFebruary 18, 2016
✔ NPI 1649641812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3530 SE 136TH AVE APT 5, Portland, OR 97236
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Other Providers at the Same Location NPPES 9

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

JANINE-ANNE LUI
Counselor (Mental Health)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
CHARLES MERCIER
Social Worker (Clinical)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
VIOLET KAWANO
Social Worker (Clinical)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
ELIZABETH AGUON
Counselor (Mental Health)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
CARISSA BURKETT
Counselor (Mental Health)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
MATTHEW PEPITONE
Counselor (Mental Health)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
JOHN CHAPLOW
Counselor (Mental Health)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535
RITA PENKIN
Social Worker (Clinical)
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236
Multnomah County (503) 719-4535

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 Jack Keenan's NPI number?

The NPI number for Jack Keenan is 1649641812. It was assigned to this individual provider in the NPPES registry on October 14, 2015.

Where is Jack Keenan located?

Jack Keenan practices at 3530 SE 136th Ave Apt 5, Portland, OR 97236. The listed phone number is (503) 719-4535.

What is Jack Keenan's specialty?

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

When was this NPI record last updated?

The NPPES record for Jack Keenan was last updated on February 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.