MEDICARE: JEANELLE TURNER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558980490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANELLE TURNER

Provider Business Mailing Address
First Line	:	6975 SW SANDBURG ST STE 250
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8088
Country	:	US
Telephone Number	:	541-527-4422
Fax Number	:

Provider Business Practice Location Address
First Line	:	6975 SW SANDBURG ST STE 250
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8088
Country	:	US
Telephone Number	:	547-527-4422
Fax Number	:

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

Provider Enumeration Date	:	04/10/2020
Last Update Date	:	04/10/2020

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Directions to “ JEANELLE TURNER ” Practice Location

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