Individual
ELISE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 CRATER LAKE AVE, MEDFORD, OR 97504-7445
(541) 772-0127
Mailing address
1750 NEBRASKA AVE BLDG A, GRANTS PASS, OR 97527-5700
(541) 956-4943
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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