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Individual

JAYNE LYNNE BLAZEVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9700 SW BEAVERTON HILLSDALE HWY, BEAVERTON, OR 97005-3306
(503) 626-9494
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
12/18/2009
Last updated
12/18/2009
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