Individual
JACQUINETTA SUZETTE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM, CADC-R
Contact information
Practice address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 927-0649
Mailing address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 927-0649
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-4426
OR
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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