MEDICARE: JESSICA STENGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	ABA-B-10242402	OR

General Provider Information

NPI Number	:	1003394156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA STENGER

Provider Business Mailing Address
First Line	:	3111 ROGUE RIVER HWY
Second Line	:
City	:	GOLD HILL
State	:	OR
Zip	:	97525-9575
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 E MAIN ST
Second Line	:	SUITE 400-15
City	:	MEDFORD
State	:	OR
Zip	:	97501-6004
Country	:	US
Telephone Number	:	503-754-5893
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	05/05/2026

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