Individual
JAMAAL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT
Contact information
Practice address
5201 SW WESTGATE DR STE 222, PORTLAND, OR 97221-2425
(757) 968-0719
Mailing address
5201 SW WESTGATE DR STE 222, PORTLAND, OR 97221-2425
(757) 968-0719
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
112650
OR
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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