Provider Demographics
NPI:1891189338
Name:ALLISON, JULES (LPC, CADC II)
Entity Type:Individual
Prefix:
First Name:JULES
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LPC, CADC II
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:ALLISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CADC II
Mailing Address - Street 1:1210 SE OAK ST STE 6
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1427
Mailing Address - Country:US
Mailing Address - Phone:971-563-8394
Mailing Address - Fax:
Practice Address - Street 1:1210 SE OAK ST STE 6
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1427
Practice Address - Country:US
Practice Address - Phone:503-238-0769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
ORC7168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No372600000XNursing Service Related ProvidersAdult Companion