Healthcare Provider Details

I. General information

NPI: 1730462961
Provider Name (Legal Business Name): JENNIFER E. JONES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER E SCHMAHL

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NE HOOD AVE STE 310
GRESHAM OR
97030-7324
US

IV. Provider business mailing address

501 NE HOOD AVE STE 310
GRESHAM OR
97030-7324
US

V. Phone/Fax

Practice location:
  • Phone: 503-208-5288
  • Fax: 503-405-4239
Mailing address:
  • Phone: 503-208-5288
  • Fax: 503-405-4239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76746
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL14617
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: