Individual
JENNIFER LYNNE BURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC/LMFT INTERN
Contact information
Practice address
1906 SW MADISON ST STE 200, PORTLAND, OR 97205-1760
(503) 730-5339
Mailing address
1906 SW MADISON ST STE 200, PORTLAND, OR 97205-1760
(503) 730-5339
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R4873
OR
106H00000X
Marriage & Family Therapist
Primary
R4874
OR
Other
Enumeration date
07/28/2017
Last updated
07/21/2022
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