Individual
DYLAN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7759 SE 72ND AVE, PORTLAND, OR 97206-7921
(503) 788-4500
Mailing address
7759 SE 72ND AVE, PORTLAND, OR 97206-7921
(503) 788-4500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/02/2012
Last updated
03/29/2019
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