Individual ProviderJessica Amber WaldoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371(503) 234-9591PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Amber Waldo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1265738835Provider TypeIndividualFull NameWaldo, Jessica AmberGenderFemaleSole ProprietorNoEnumeration Date1/31/2011Last Updated1/31/2011Contact InformationPractice LocationPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxMailing LocationMailing Address3415 SE Powell Blvd., Parry Center, Portland, OR 97202Phone(503) 234-9591FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer