Individual
JEANINE RITA DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACD III
Contact information
Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Mailing address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
94-10-87
OR
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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