Individual
JESSE CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
305 PACIFIC AVE S STE C, KELSO, WA 98626-1638
(360) 644-1027
Mailing address
2216 SE 130TH AVE, VANCOUVER, WA 98683-6573
(360) 635-3867
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61334546
WA
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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