Individual
MRS. JESSICA L WYNANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1915 NE STUCKI AVE STE 308, HILLSBORO, OR 97006-6951
(503) 813-3376
Mailing address
1915 NE STUCKI AVE STE 308, HILLSBORO, OR 97006-6951
(503) 476-1013
(971) 209-7262
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C8592
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500807379
—
OR
Enumeration date
09/03/2021
Last updated
12/30/2024
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