Provider Demographics
NPI:1780746503
Name:KUSHNER, JESSICA D (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:D
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:H
Other - Last Name:DICKSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:OHSU, DIV OF CV MEDICINE, UHN-62
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-3959
Mailing Address - Fax:503-494-5049
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:OHSU, DIV OF CV MEDICINE, UHN-62
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-3959
Practice Address - Fax:503-494-5049
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS