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General NPI Number Information
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NPI Number | 1922942143
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Entity Type | Individual
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Provider Name | JESSICA YOUNG
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Gender | Female
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 161 NE 82ND AVE APT 146
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City | PORTLAND
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State | OR
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Zip | 97220-6004
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Country | US
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Telephone | 503-703-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 19600 NE 3RD ST APT 146 APT. 146
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City | CAMAS
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State | WA
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Zip | 98607-7811
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Country | US
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Telephone | 503-703-3010
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 504690
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License Number State | OR
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