Individual
DEBORAH ANN JEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA2, QMHA
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(971) 322-5295
Mailing address
5627 NE SIMPSON ST, PORTLAND, OR 97218-2329
(971) 322-5295
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
19-QMHA-I-00257
OR
376K00000X
Nurse's Aide
201110681CNA
OR
Other
Enumeration date
03/01/2020
Last updated
09/21/2021
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