Individual provider · Type 1 NPI

Jessica L. Spain, CADC I/QMHA-R

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1013430271 Active

Practice location

1631 SW Columbia St
Portland, OR 97201-6025

Fax (503) 231-1654

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X19-QMHA-R-0061 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X20-03-16U (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1013430271

Jessica L. Spain, CADC I/QMHA-R's National Provider Identifier is 1013430271, issued on Jul 19, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Jan 6, 2021.