Individual
JORDAN LEVI BENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
(503) 598-0934
Mailing address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
(503) 598-0934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2642
OR
171M00000X
Case Manager/Care Coordinator
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—
Other
Enumeration date
09/20/2023
Last updated
04/15/2025
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