Individual
JESSICA CONTRERAS MCGOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2333 SE 12TH AVE, PORTLAND, OR 97214-5323
(503) 235-0031
Mailing address
2020 SE POWELL BLVD, PORTLAND, OR 97202-2345
(503) 233-6121
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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