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General NPI Number Information
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NPI Number | 1376401943
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Entity Type | Individual
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Provider Name | JENNELL RODEN
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Gender | Female
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3611 SE 20TH AVE STE 202
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City | PORTLAND
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State | OR
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Zip | 97202-2967
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Country | US
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Telephone | 503-334-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 16333 SE DAGMAR RD
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City | PORTLAND
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State | OR
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Zip | 97267-6356
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Country | US
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Telephone | 503-753-6842
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | R12591
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License Number State | OR
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