Individual
JENNIFER WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
18417 SE OAK ST, PORTLAND, OR 97233-4850
(971) 727-8026
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/14/2023
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