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Jessica L Spain, CADCI/QMHA-R
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1013430271

Jessica L Spain is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Jessica L Spain practices in Portland, OR and has the professional credentials of CADCI/QMHA-R. The NPI Number for Jessica L Spain is 1013430271 and holds a License No. 19-QMHA-R-0061 (Oregon).

The current practice location address for Jessica L Spain is 1631 Sw Columbia St, Portland, OR and can be reached out via phone at 503-231-2641 and via fax at 503-231-1654.

Location: 1631 Sw Columbia St, Portland, OR, 97205-1715
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Provider Profile Details
NPI Number
1013430271
Provider Name
Jessica L Spain
Credential
CADCI/QMHA-R
Provider Entity Type
Individual
Gender
Female
Address
1631 Sw Columbia St, Portland, OR, 97205-1715
Phone Number
503-231-2641
Fax Number
503-231-1654
Provider Enumeration Date
07/19/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500774907 05 OR
500738245 05 OR
institution
Provider Business Practice Location Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider Business Mailing Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
20-03-16U (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
19-QMHA-R-0061 (Oregon)
Definition
Definition to come...
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