Individual
JACOB E SKOKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
231 SE 12TH AVENUE, PORTLAND, OR 97214-1342
(503) 546-9975
(503) 546-9976
Mailing address
232 NW 6TH AVENUE, PORTLAND, OR 97209-3609
(503) 200-3923
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08-08-39
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
03/28/2007
Last updated
01/20/2011
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