Individual
LAMAYA T JARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS/QMHA-R
Contact information
Practice address
1310 SW 17TH AVE, PORTLAND, OR 97201-2522
(503) 231-2641
(503) 467-4077
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
23-QMHA-R-3567
OR
175T00000X
Peer Specialist
Primary
THW000106422
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500815209
—
OR
Enumeration date
01/31/2023
Last updated
09/05/2023
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