Individual
JESSICA RIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
595 CHEMAWA RD N, KEIZER, OR 97303-5300
(503) 399-3147
Mailing address
408 SW MONROE AVE # 150, CORVALLIS, OR 97333-7210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
Primary
162248
OR
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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