Provider Demographics
NPI:1982933578
Name:RICKER, JESSICA MARGARETROSE MAKOHON (MA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARGARETROSE MAKOHON
Last Name:RICKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:MAKOHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC INTERN
Mailing Address - Street 1:4585 SW 185TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97078-1557
Mailing Address - Country:US
Mailing Address - Phone:503-619-1943
Mailing Address - Fax:503-619-1949
Practice Address - Street 1:4585 SW 185TH AVE
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97078-1557
Practice Address - Country:US
Practice Address - Phone:503-619-1943
Practice Address - Fax:503-619-1949
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health