Individual
JESSICA DENICE PANKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
200 SE HAILEY AVE STE 204, PENDLETON, OR 97801-3072
(541) 663-4104
(541) 663-4142
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 663-4104
(541) 663-4142
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
20-CRM-208
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-CRM-208
MHACBO
OR
05
—
500793036
—
OR
Enumeration date
08/20/2020
Last updated
01/26/2026
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