Individual
JENNIFER MCCRACKEN GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
7440 W MARGINAL WAY S, SEATTLE, WA 98108
(206) 768-1990
Mailing address
7440 W MARGINAL WAY S, SEATTLE, WA 98108-4141
(206) 768-1990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60858642
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60858642
CEMICAL DEPENDENCY PROFESSIONAL CERTIFICATION
WA
Enumeration date
10/10/2018
Last updated
04/10/2019
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