Provider Demographics
NPI:1013180256
Name:PODD, JESSI KRISTIN (LPC, CADC III)
Entity Type:Individual
Prefix:MRS
First Name:JESSI
Middle Name:KRISTIN
Last Name:PODD
Suffix:
Gender:F
Credentials:LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9895 SW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-9124
Mailing Address - Country:US
Mailing Address - Phone:503-270-7502
Mailing Address - Fax:503-935-5884
Practice Address - Street 1:4905 SW SCHOLLS FERRY RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1605
Practice Address - Country:US
Practice Address - Phone:503-270-7502
Practice Address - Fax:503-935-5884
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor