Provider Demographics
NPI:1942863428
Name:JENKINS, SHAELYN MAE (LCSW, MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHAELYN
Middle Name:MAE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7051
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7051
Mailing Address - Country:US
Mailing Address - Phone:503-560-5822
Mailing Address - Fax:
Practice Address - Street 1:4950 NE BELKNAP CT STE 205
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5115
Practice Address - Country:US
Practice Address - Phone:503-560-5822
Practice Address - Fax:888-503-2864
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA815491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical