Provider Demographics
NPI:1205277084
Name:CAIN, JILL ELAINE (MS, LPC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ELAINE
Last Name:CAIN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29545 SW COFFEE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-3079
Mailing Address - Country:US
Mailing Address - Phone:503-318-3083
Mailing Address - Fax:503-893-3044
Practice Address - Street 1:28925 SW BOBERG RD
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8218
Practice Address - Country:US
Practice Address - Phone:503-318-3083
Practice Address - Fax:503-893-3044
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional