Individual provider · Type 1 NPI

Jacqueline Grace Haines

Mental Health Counselor · Portland, OR

NPI number 1316686264 Active

Practice location

17710 NE Halsey St
Portland, OR 97230-6734

Fax (503) 387-5279

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1316686264

Jacqueline Grace Haines's National Provider Identifier is 1316686264, issued on May 31, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on May 12, 2025.