Provider Demographics
NPI:1780904201
Name:CLAYPOOL, JESSICA SUSAN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUSAN
Last Name:CLAYPOOL
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 1:941 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4611
Mailing Address - Country:US
Mailing Address - Phone:541-686-4310
Mailing Address - Fax:541-868-1596
Practice Address - Street 1:941 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4611
Practice Address - Country:US
Practice Address - Phone:541-686-4310
Practice Address - Fax:541-868-1596
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker