Individual
JESSICA L LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9450 SW BARNES RD STE 200, PORTLAND, OR 97225-6638
(503) 216-2025
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L8397
OR
1041C0700X
Clinical Social Worker
Primary
L8397
OR
Other
Enumeration date
03/14/2011
Last updated
01/15/2021
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