person
Jamie D Gottlieb, CADC-R/QMHA-I
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1619625910

Jamie D Gottlieb is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Jamie D Gottlieb practices in Portland, OR and has the professional credentials of CADC-R/QMHA-I. The NPI Number for Jamie D Gottlieb is 1619625910 and holds a License No. 23-QMHA-I-003642 (Oregon).

The current practice location address for Jamie D Gottlieb is 1310 Sw 17Th Ave, Portland, OR and can be reached out via phone at 503-231-2641 and via fax at 503-467-4077.

Location: 1310 Sw 17Th Ave, Portland, OR, 97205-1715
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Provider Profile Details
NPI Number
1619625910
Provider Name
Jamie D Gottlieb
Credential
CADC-R/QMHA-I
Provider Entity Type
Individual
Gender
Male
Address
1310 Sw 17Th Ave, Portland, OR, 97205-1715
Phone Number
503-231-2641
Fax Number
503-467-4077
Provider Enumeration Date
03/15/2022
Last Update Date
04/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500817750 05 OR
500804360 05 OR
institution
Provider Business Practice Location Address Details
Address
1310 Sw 17Th Ave
City
State
Zip
97201-2522
Phone Number
503-231-2641
Fax Number
503-467-4077
person
Provider Business Mailing Address Details
Address
1310 Sw 17Th Ave
City
State
Zip
97201-2522
Phone Number
503-231-2641
Fax Number
503-467-4077
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
T-23-2550 (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.
23-QMHA-I-003642 (Oregon)
Definition
Definition to come...
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