Individual
JILLYAN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-3822
(503) 489-7077
Mailing address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-3822
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/14/2018
Last updated
03/20/2026
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