Brunelle, Jessica
Brunelle, Jessica is an sole proprietor health care provider with primary practice located at 831 Nw Council Dr Ste 300 , Gresham OR 97030-3725. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Brunelle, Jessica can be contacted via phone (503) 258-4281.Contact Information
Primary practice address
831 Nw Council Dr Ste 300
Gresham OR 97030-3725
Phone: (503) 258-4281
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1770836934 |
|---|---|
| LBN Legal business name | Brunelle, Jessica |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2012 |
| Last updated | Jul 27th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770836934 | NPPES |
| Oregon | MEDICAID | 274147 |
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