Healthcare Provider Details

I. General information

NPI: 1326458753
Provider Name (Legal Business Name): JESSICA MARIE YEAGER PMHNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA MARIE BERQUIST JESSICA BERQUIST

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1178 CHARNELTON ST
EUGENE OR
97401-3431
US

IV. Provider business mailing address

1178 CHARNELTON ST
EUGENE OR
97401-3431
US

V. Phone/Fax

Practice location:
  • Phone: 541-777-8879
  • Fax: 541-391-5934
Mailing address:
  • Phone: 541-777-8879
  • Fax: 541-942-9310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201800903RN
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201801007NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: