Jenna Marie Paulsen, CL61184592

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3400 SE 196TH Ave Ste 102
Camas, WA 98607-8862

Phone

(360) 975-0512

NPI assigned

Mar 29, 2022

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Restored Life Counseling

  • Counselor
  • Glendale, AZ
  • NPI 1356847008
  NPD
• Lacamas Counseling LLC

  • Mental Health Counselor
  • Camas, WA
  • NPI 1730852971
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1538809595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 NE 107TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SE 196TH AVE STE 102",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078862",
            "telephone_number": "360-975-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CL61184592",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ankur Nilesh Patel, M.D., M.S.
• Neha Patel, M.D.
• Laura Pathan, PHARMD
• Tammy Lyn Patterson, LMP
• Carrie Pattison, LAC, RN
• Aaron Noel Payne, PTA
• Peak Motion, PLLC (Fyzical Therapy & Balance Centers)
• Sharon Muff Peddie, OTR/L
• Dina Peganoff, PHYSICAL THERAPIST A
• Pelvic Pro Therapy, LLC

• Student in an Organized Health Care Education/Training Program in Camas, WA
• Providers in Camas, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.