Individual provider · Type 1 NPI
Jaclyn Grace Evans
Addiction (Substance Use Disorder) Counselor · Portland, OR
NPI number
1831743293
Active
Practice location
1122 NE 122nd Ave
Portland, OR 97230-2081
Mailing address
1122 NE 122nd Ave Ste A102
Portland, OR 97230-2082
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
3 other providers at this address
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- Jacob Erin Scott, CADCAddiction (Substance Use Disorder) Counselor Portland, OR NPI 1003578634
About NPI 1831743293
Jaclyn Grace Evans's National Provider Identifier is 1831743293, issued on Jul 24, 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 24, 2019.