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NPI Code Detail

MEDICARE: JESSE AARRON LOOMIS

MEDICARE: JESSE AARRON LOOMIS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134051493
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE AARRON LOOMIS
Provider Business Mailing Address
First Line : 3587 HEATHROW WAY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4004
Country : US
Telephone Number : 541-858-8170
Fax Number : 541-858-8167
Provider Business Practice Location Address
First Line : 2808 SE BALFOUR ST
Second Line :
City : MILWAUKIE
State : OR
Zip : 97222-6426
Country : US
Telephone Number : 503-659-2575
Fax Number : 503-659-5182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ JESSE AARRON LOOMIS ” Practice Location

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