Individual
BRIDGET JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 HILYARD ST STE 570, EUGENE, OR 97401-8168
(458) 205-7070
(458) 205-7089
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 684-4168
(541) 684-4156
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16-05-21
OR
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719317
—
OR
Enumeration date
02/08/2016
Last updated
01/29/2018
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