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Individual

NICOLE ALEXANDRA JANKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2045 SILVERTON RD NE, SALEM, OR 97301-0100
(503) 588-5351
Mailing address
625 SE SHERIDAN RD APT D1, SHERIDAN, OR 97378-2008
(503) 849-1159

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
10/01/2024
Last updated
10/01/2024
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