Individual provider · Type 1 NPI
Valyn Lee Keith-Jackson, CADC 1
Addiction (Substance Use Disorder) Counselor · Gresham, OR
NPI number
1609631456
Active
Practice location
620 NE 2nd St
Gresham, OR 97030-7514
Fax (503) 912-5740
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 24-R-29 (OR) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | SC3245 (MD) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1609631456
Valyn Lee Keith-Jackson, CADC 1's National Provider Identifier is 1609631456, issued on Feb 20, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Oct 23, 2024.