Individual
JESSE SAMUEL KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10373 NE HANCOCK ST STE 200, PORTLAND, OR 97220-3873
(503) 261-6136
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L12977
OR
1041C0700X
Clinical Social Worker
LCSW-18630
AZ
Other
Enumeration date
12/07/2015
Last updated
12/28/2021
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