Individual
JESSIE GROW HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 444-1030
(541) 444-9695
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030
(541) 444-9695
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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