Provider Demographics
NPI:1255043394
Name:VISSCHER, JILLIAN LAINE (LMHC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:LAINE
Last Name:VISSCHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:VISSCHER
Other - Last Name:AULBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18861 ALLEGHENY DR
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-3905
Mailing Address - Country:US
Mailing Address - Phone:503-887-9210
Mailing Address - Fax:
Practice Address - Street 1:1498 SE TECH CENTER PL STE 300
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5509
Practice Address - Country:US
Practice Address - Phone:360-619-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61582831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health