Healthcare Provider Details

I. General information

NPI: 1649205402
Provider Name (Legal Business Name): JONDRA ANN PENNINGTON M.S., M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 PEARL ST
EUGENE OR
97401-4010
US

IV. Provider business mailing address

1551 PEARL ST
EUGENE OR
97401-4010
US

V. Phone/Fax

Practice location:
  • Phone: 541-518-9733
  • Fax:
Mailing address:
  • Phone: 541-517-9733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC36372
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC3551
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: