Provider Demographics
NPI:1053576116
Name:CEMENSKA, JESSICA RAINEY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RAINEY
Last Name:CEMENSKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E EVERGREEN BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3331
Mailing Address - Country:US
Mailing Address - Phone:360-600-9133
Mailing Address - Fax:
Practice Address - Street 1:400 E EVERGREEN BLVD
Practice Address - Street 2:SUITE #301
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3331
Practice Address - Country:US
Practice Address - Phone:360-600-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002570106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist