Individual
JENNIFER LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CD
Contact information
Practice address
715 SW DORION AVE, PENDLETON, OR 97801-2070
(541) 429-8800
(541) 429-8822
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 429-8844
(541) 429-8822
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
374J00000X
Doula
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
CERTIFIED BIRTH DOULA
OR
Enumeration date
06/10/2021
Last updated
01/22/2026
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