Individual
JILL VIRGINIA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 228-7134
(503) 273-8431
Mailing address
4040 N COMMERCIAL AVE, PORTLAND, OR 97227-1316
(503) 228-7134
(503) 273-8431
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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