Basic Information
| Provider Information | |||||||||
| NPI: | 1013556711 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BESNER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | LPC INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5030 SE STEPHENS ST APT 216 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972153288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328873085 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10011 SE DIVISION ST STE 203 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972661354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032552343 | ||||||||
| FaxNumber: | 5032552344 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2019 | ||||||||
| LastUpdateDate: | 12/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | R6147 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.