Individual provider · Type 1 NPI

Jacob Andrew Welliver

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1821640947 Active

Practice location

847 NE 19th Ave Ste 100
Portland, OR 97232-2684

Call (503) 238-0769 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1821640947

Jacob Andrew Welliver's National Provider Identifier is 1821640947, issued on Jul 9, 2019. 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 Jul 9, 2019.