Individual
JORESA DIONDRA JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3231 SE 50TH AVE, PORTLAND, OR 97206-2248
(503) 238-5203
Mailing address
18088 SE MARKET ST APT 112, PORTLAND, OR 97233-5056
(971) 865-1907
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-CRM-1585
OR
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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