Provider Demographics
NPI:1689355299
Name:MENA, JESSICA C (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
Last Name:MENA
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 SW CASCADE AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7126
Mailing Address - Country:US
Mailing Address - Phone:602-703-4979
Mailing Address - Fax:
Practice Address - Street 1:5909 SE HARNEY DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-0879
Practice Address - Country:US
Practice Address - Phone:602-703-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist