Individual
JESSE N SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II/QMHA-I
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
12104 SE TIBBETTS ST, PORTLAND, OR 97266-1049
(971) 212-5312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-01-09
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-04-13
OR
101YM0800X
Mental Health Counselor
19-QMHA-I-00297
OR
101YM0800X
Mental Health Counselor
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500700056
—
OR
05
—
500722603
—
OR
Enumeration date
02/04/2016
Last updated
07/11/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us