Provider Demographics
NPI:1740659465
Name:LINTON, JENNIFER JO
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JO
Last Name:LINTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 SILVERTON RD NE STE B
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0100
Mailing Address - Country:US
Mailing Address - Phone:503-588-5351
Mailing Address - Fax:503-361-2666
Practice Address - Street 1:2421 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1220
Practice Address - Country:US
Practice Address - Phone:503-588-5352
Practice Address - Fax:503-585-4990
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health