Individual
JODI SUMMER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16520 SW UPPER BOONES FERRY RD, PORTLAND, OR 97224-7686
(971) 250-8014
Mailing address
16520 SW UPPER BOONES FERRY RD STE 240, PORTLAND, OR 97224-7659
(971) 250-8014
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R11288
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
01/20/2026
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