Individual provider · Type 1 NPI
Jetta Kimberly Luciano, CDP
Addiction (Substance Use Disorder) Counselor · Vancouver, WA
NPI number
1306073515
Active
Practice location
6926 E Fourth Plain Blvd, Suite #100
Vancouver, WA 98661-7369
Fax (360) 737-3451
Mailing address
PO Box 1337
Vancouver, WA 98666-1337
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | CP 00004432 (WA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
3 other providers at this address
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About NPI 1306073515
Jetta Kimberly Luciano, CDP's National Provider Identifier is 1306073515, issued on Jun 15, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vancouver, WA. The record was last updated on Jul 24, 2013.