Provider Demographics
NPI:1689970253
Name:PIERCE, JENNA (MS)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:FAHLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6 CENTERPOINTE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8660
Mailing Address - Country:US
Mailing Address - Phone:503-644-1171
Mailing Address - Fax:503-914-0335
Practice Address - Street 1:4510 SW HALL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0504
Practice Address - Country:US
Practice Address - Phone:503-644-1171
Practice Address - Fax:503-914-0335
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)