Provider Demographics
NPI:1730228966
Name:MERKLE, JERILEE (MSW)
Entity type:Individual
Prefix:
First Name:JERILEE
Middle Name:
Last Name:MERKLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1329
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-1329
Mailing Address - Country:US
Mailing Address - Phone:503-472-9797
Mailing Address - Fax:503-876-4594
Practice Address - Street 1:1004 NE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4932
Practice Address - Country:US
Practice Address - Phone:503-472-9797
Practice Address - Fax:503-876-4594
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical