=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700497377
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEFFREY ROLLAND MEUSER LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2020
-----------------------------------------------------
Last Update Date | 01/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11630 SE 40TH AVE
-----------------------------------------------------
City | MILWAUKIE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222-6195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-804-7783
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14415 SW 94TH CT
-----------------------------------------------------
City | TIGARD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97224-5859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-804-7783
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | R5662
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------