Individual
MS. JAMA LYNN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
215 N G ST, LAKEVIEW, OR 97630-1417
(541) 947-6021
(541) 947-6020
Mailing address
87127 CHRISTMAS VALLEY HWY, CHRISTMAS VALLEY, OR 97641-2298
(541) 947-6021
(541) 576-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20-10-24
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930577593
—
OR
Enumeration date
05/16/2018
Last updated
11/16/2022
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