Healthcare Provider Details

I. General information

NPI: 1114211430
Provider Name (Legal Business Name): JENIFFER DUNCAN LPC, ATR, CADC I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4207 SE WOODSTOCK BLVD # 398
PORTLAND OR
97206-6267
US

IV. Provider business mailing address

5207 SE WOODSTOCK BLVD 398
PORTLAND OR
97206
US

V. Phone/Fax

Practice location:
  • Phone: 503-974-4140
  • Fax:
Mailing address:
  • Phone: 503-974-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC3022
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: