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NPI Code Detail

MEDICARE: JENNIFER GIFFORD

MEDICARE: JENNIFER GIFFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194672774
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER GIFFORD
Provider Business Mailing Address
First Line : 12359 SE HUBBARD RD
Second Line :
City : CLACKAMAS
State : OR
Zip : 97015-8219
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1010 5TH ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-2444
Country : US
Telephone Number : 503-594-4750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ JENNIFER GIFFORD ” Practice Location

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