Individual
JESSICA L SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I/QMHA-R
Contact information
Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20-03-16U
OR
101YM0800X
Mental Health Counselor
19-QMHA-R-0061
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500738245
—
OR
05
—
500774907
—
OR
Enumeration date
07/19/2017
Last updated
01/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us