Provider Demographics
NPI:1679351993
Name:MORRIS, JESSE LEE (PMHNP)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8132 MYSTICAL LN SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-8967
Mailing Address - Country:US
Mailing Address - Phone:971-239-8008
Mailing Address - Fax:
Practice Address - Street 1:6400 SE LAKE RD STE 155
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97222-2137
Practice Address - Country:US
Practice Address - Phone:503-447-3285
Practice Address - Fax:503-917-4971
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10016058363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health