Individual
JESSICA COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MCR
Contact information
Practice address
2821 DAGGETT AVE STE 100, KLAMATH FALLS, OR 97601-1130
(541) 274-4611
Mailing address
11719 SE BOISE ST, PORTLAND, OR 97266-2123
(520) 820-5041
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2025
Last updated
03/22/2025
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