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Individual

JESSICA A RADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
1620 E 12TH ST, THE DALLES, OR 97058-3213
(541) 296-9151
(541) 296-9156
Mailing address
638 DAVENPORT RD, MOSIER, OR 97040-9500
(541) 490-2590

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201601539NP-PP
OR

Other

Enumeration date
01/14/2014
Last updated
04/14/2016
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