Provider Demographics
NPI:1235929274
Name:LANDWEHR, JESSI JAYNE
Entity type:Individual
Prefix:
First Name:JESSI
Middle Name:JAYNE
Last Name:LANDWEHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 NE ZIMRI DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-6959
Mailing Address - Country:US
Mailing Address - Phone:206-786-3667
Mailing Address - Fax:
Practice Address - Street 1:609 NE BAKER ST STE 260
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4950
Practice Address - Country:US
Practice Address - Phone:971-213-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health