Individual
MS. JENNIFER LYNN RICHIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 200-7055
Mailing address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 200-7055
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
077416
NY
251S00000X
Community/Behavioral Health Agency
077416
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568401347
OUTSIDE IN
OR
Enumeration date
04/03/2009
Last updated
10/10/2014
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