Healthcare Provider Details

I. General information

NPI: 1275456287
Provider Name (Legal Business Name): JO PIERSON LMFT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

13140 SW BLACK WALNUT ST
TIGARD OR
97224-6147
US

IV. Provider business mailing address

1616 11TH AVE SW
OLYMPIA WA
98502-5829
US

V. Phone/Fax

Practice location:
  • Phone: 661-609-5772
  • Fax:
Mailing address:
  • Phone: 661-609-5772
  • Fax: 503-678-9751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE MECHIKOFF
Title or Position: PRACTICE MANAGER
Credential:
Phone: 503-470-1560