Individual
JENNA M CHANTARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CADCII, QMHP
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-03-04
OR
101YM0800X
Mental Health Counselor
19-QMHPC-00131
OR
104100000X
Social Worker
—
—
Other
Enumeration date
04/22/2009
Last updated
06/13/2022
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