Provider Demographics
NPI:1871021170
Name:DOBIE, JENNIFER A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:DOBIE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 E BURNSIDE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1689
Mailing Address - Country:US
Mailing Address - Phone:503-825-2110
Mailing Address - Fax:503-825-2130
Practice Address - Street 1:2304 E BURNSIDE ST STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1689
Practice Address - Country:US
Practice Address - Phone:503-825-2110
Practice Address - Fax:503-825-2130
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL72271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical