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Individual

WILLIAM J JENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRM

Contact information

Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-CRM-035
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500730542
OR
Enumeration date
02/06/2012
Last updated
07/11/2022
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