MEDICARE: JENNA ANNE ESTEP PCCT

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
1	101YM0800X	Mental Health Counselor	R9371	OR

General Provider Information

NPI Number	:	1891487278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA ANNE ESTEP PCCT

Provider Business Mailing Address
First Line	:	PO BOX 873882
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98687-3882
Country	:	US
Telephone Number	:	503-320-7136
Fax Number	:	503-776-7719

Provider Business Practice Location Address
First Line	:	1827 NE 44TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-1443
Country	:	US
Telephone Number	:	503-320-7136
Fax Number	:	503-776-7719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	03/19/2026

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Directions to “ JENNA ANNE ESTEP PCCT” Practice Location

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