Provider Information for 1013556711
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JESSICA L BESNER LPC intern
Sex: Female
NPI: 1013556711
Last Updated: 2019-12-27
Certification Date: 2019-12-27
Certification Date: 2019-12-27
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1013556711 | ||||||||
| Enumeration Date | 2019-12-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5030 SE STEPHENS ST APT 216 PORTLAND, OR 97215-3288 United States Phone: 732-887-3085 | Fax: | ||||||||
| Primary Practice Address | 10011 SE DIVISION ST STE 203 PORTLAND, OR 97266-1354 United States Phone: 503-255-2343 | Fax:503-255-2344 | ||||||||
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