| Jessica Kieras Llc | |
|
3939 Ne Hancock St Suite 214 Portland OR 97212-5321 | |
| (503) 489-7134 | |
| Not Available |
| Full Name | Jessica Kieras Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3939 Ne Hancock St, Portland, Oregon |
| Authorized Official Name and Position | Jessica Kieras (PRESIDENT) |
| Authorized Official Contact | 5034897134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Kieras Llc 3939 Ne Hancock St Suite 214 Portland OR 97212-5321 Ph: () - | Jessica Kieras Llc 3939 Ne Hancock St Suite 214 Portland OR 97212-5321 Ph: (503) 489-7134 |
| NPI Number | 1215478300 |
|---|---|
| Provider Enumeration Date | 03/09/2017 |
| Last Update Date | 03/09/2017 |
| Medicare PECOS PAC ID | 1355628538 |
|---|---|
| Medicare Enrollment ID | O20170426002483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215478300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2198 (Oregon) | Primary |
| Provider Name | Jessica E Kieras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134314735 PECOS PAC ID: 9234392747 Enrollment ID: I20120521000450 |
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