Individual
MS. JENNIFER LYNN CANAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
505 SE ADAMS AVE, CHEHALIS, WA 98532-3031
(360) 266-5029
(360) 740-2551
Mailing address
4317 NE 66TH AVE APT N141, VANCOUVER, WA 98661-3291
(360) 521-2566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60411031
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60411031
DEPARTMENT OF HEALTH
WA
05
—
CP60411031
—
WA
Enumeration date
12/28/2018
Last updated
12/28/2018
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