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General NPI Number Information
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NPI Number | 1174476204
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Entity Type | Individual
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Provider Name | JORDAN ABREE VILLINES PPS
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Gender | Female
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 314 NE 19TH AVE
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City | PORTLAND
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State | OR
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Zip | 97232-2829
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Country | US
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Telephone | 503-323-9818
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Fax | 503-548-4013
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Provider Business Mailing Address
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Address Line | 5311 N VANCOUVER AVE
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City | PORTLAND
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State | OR
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Zip | 97217-2731
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Country | US
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Telephone | 503-239-8181
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Fax | 503-548-4013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 116169
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License Number State | OR
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