Individual
MARY JEDDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6902 SE LAKE RD, MILWAUKIE, OR 97267-2148
(971) 400-9256
Mailing address
6200 SE KING RD, PORTLAND, OR 97222-2891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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