Individual
JORDANNA BLAIR HALE ZAOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
727 NE 24TH AVE, PORTLAND, OR 97232-2222
(503) 228-9229
Mailing address
3024 SW FLORIDA CT APT C, PORTLAND, OR 97219-1871
(503) 754-4174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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