Individual
JENNA LEE CARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OMHA I
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
1520 23RD ST SE APT 315, SALEM, OR 97302-1695
(503) 851-9548
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
10/22/2024
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