Jesse Fuller is a Peer Specialist based in Portland, OR. Jesse Fuller practices in Portland, OR. The NPI Number for Jesse Fuller is 1720851728 and holds a License No. (Oregon).
The current practice location address for Jesse Fuller is 1030 Ne Couch St, Portland, OR and can be reached out via phone at 503-239-8400.
Location: 1030 Ne Couch St, Portland, OR, 97214-1328
Provider Profile Details
NPI Number
1720851728
Provider Name
Jesse Fuller
Credential
Provider Entity Type
Individual
Gender
Male
Address
1030 Ne Couch St, Portland, OR, 97214-1328
Phone Number
503-239-8400
Fax Number
Provider Enumeration Date
11/01/2023
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
1030 Ne Couch St
City
State
Zip
97232-3067
Phone Number
503-239-8400
Fax Number
Provider Business Mailing Address Details
Address
1030 Ne Couch St
City
State
Zip
97232-3067
Phone Number
503-239-8400
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
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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