Provider Demographics
NPI:1659806974
Name:NOBLE, JASMINE JEWEL
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:JEWEL
Last Name:NOBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:JEWEL
Other - Last Name:CORPUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 82819
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9700 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:ANNEX B
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3306
Practice Address - Country:US
Practice Address - Phone:503-626-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)