Provider Demographics
NPI:1659745990
Name:BRIGHTMAN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BRIGHTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:DENIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OR
Mailing Address - Zip Code:97391-1613
Mailing Address - Country:US
Mailing Address - Phone:541-819-0450
Mailing Address - Fax:
Practice Address - Street 1:321 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OR
Practice Address - Zip Code:97391-1613
Practice Address - Country:US
Practice Address - Phone:541-819-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor