Individual
JESSICA RAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2955 N HWY 97, BEND, OR 97703-7559
(541) 203-0474
(541) 610-1692
Mailing address
PO BOX 1041, BEND, OR 97709-1041
(541) 203-0474
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
12/11/2025
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