Individual provider · Type 1 NPI

Jerry Phillips

Mental Health Counselor · Portland, OR

NPI number 1831489574 Active

Practice location

17710 NE Halsey St
Portland, OR 97230-6734

Fax (503) 387-5279

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XPROFESSIONALLICENSE

Mental Health Counselor: Definition to come...

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About NPI 1831489574

Jerry Phillips's National Provider Identifier is 1831489574, issued on Apr 14, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on May 12, 2025.