Jessica Rochelle Bradburn, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R8333 Issued in OR

Practice address

9 Monroe Pkwy Ste 205
Lake Oswego, OR 97035-8864

Phone

(503) 583-2365

NPI assigned

Sep 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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 and National Provider Directory roles.

• Graced by Faith LLC

  • Professional Counselor
  • Lake Oswego, OR
  • NPI 1053282228
  NPD

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1891522595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MONROE PKWY STE 250",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358866",
            "telephone_number": "503-583-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MONROE PKWY STE 205",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358864",
            "telephone_number": "503-583-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURN",
        "first_name": "JESSICA",
        "middle_name": "ROCHELLE",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R8333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Borgen
• Lilian Renata Bornio Carrillo
• Pamela K Bosa, NP
• Carlie Boswell
• Larry Bowden, DMD
• John Rodgers Braddock, M.D.
• Shannon Braden, ND
• Jacqueline Bradford, MA, MFT, NCC
• Bradley E Sievert DMD PC
• Nicholas Bradshaw, MT

• Mental Health Counselor in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.