Healthcare Provider Details

I. General information

NPI: 1194680462
Provider Name (Legal Business Name): JADEN FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18765 SW BOONES FERRY RD
TUALATIN OR
97062-8496
US

IV. Provider business mailing address

1095 CLEARVIEW AVE NE APT 103
KEIZER OR
97303-5021
US

V. Phone/Fax

Practice location:
  • Phone: 503-612-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: