MEDICARE: MS. JENNIFER LEE PAGE MS, APCC

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	101YP2500X	Professional Counselor	21316	CA

General Provider Information

NPI Number	:	1548945884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LEE PAGE MS, APCC

Provider Business Mailing Address
First Line	:	6443 NE 33RD AVE UNIT B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-7225
Country	:	US
Telephone Number	:	909-262-5524
Fax Number	:

Provider Business Practice Location Address
First Line	:	6443 NE 33RD AVE UNIT B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-7225
Country	:	US
Telephone Number	:	909-262-5524
Fax Number	:

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

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	06/08/2026

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