Individual
ADRIANNA JUMPING EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
1003 E MAIN ST, SUITE 104, MEDFORD, OR 97504-7448
(541) 779-1282
(541) 779-2081
Mailing address
1003 E MAIN ST, SUITE 104, MEDFORD, OR 97504-7448
(541) 779-1282
(541) 779-2081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-R-45
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134150
—
OR
Enumeration date
03/30/2016
Last updated
03/30/2016
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