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Jennifer Lustbader, CMR
Peer Specialist in Beaverton, Oregon
NPI 1639555600

Jennifer Lustbader is a Peer Specialist based in Beaverton, OR. Jennifer Lustbader practices in Beaverton, OR and has the professional credentials of CMR. The NPI Number for Jennifer Lustbader is 1639555600 and holds a License No. 15-CRM-111 (Oregon).

The current practice location address for Jennifer Lustbader is 14760 Sw Forest Dr, Beaverton, OR and can be reached out via phone at 503-860-7481.

Location: 14760 Sw Forest Dr, Beaverton, OR, 97007-5117
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639555600
Provider Name
Jennifer Lustbader
Credential
CMR
Provider Entity Type
Individual
Gender
Female
Address
14760 Sw Forest Dr, Beaverton, OR, 97007-5117
Phone Number
503-860-7481
Fax Number
Provider Enumeration Date
07/31/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
15-CRM-111 01 OR UNDETERMINED
institution
Provider Business Practice Location Address Details
Address
14760 Sw Forest Dr
City
Beaverton
State
Oregon
Zip
97007-5117
Phone Number
503-860-7481
Fax Number
person
Provider Business Mailing Address Details
Address
14760 Sw Forest Dr
City
Beaverton
State
Oregon
Zip
97007-5117
Phone Number
503-860-7481
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
15-CRM-111 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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