Individual provider · Type 1 NPI

Jacqueline B. Pancoast, CADC I

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1992056717 Active

Practice location

1949 SE 122nd Ave
Portland, OR 97233-1303

Call (971) 271-6313 Map

Mailing address

232 NW 6th Ave
Portland, OR 97209-3609

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X04-11-30 (OR)

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

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About NPI 1992056717

Jacqueline B. Pancoast, CADC I's National Provider Identifier is 1992056717, issued on Sep 20, 2012. 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 Sep 20, 2012.