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Contact Information

JAKE SANDERS
2222 EAST POWELL BOULEVARD
GRESHAM, OR97080
 Phone: 503-669-4300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JAKE SANDERS · (Male)

NPI Number 1467138446
Status Active
Credentials
Entity Individual
Enumeration date 06/26/2023
Last updated 04/06/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • OR License # ORR305
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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