Individual
DEANNA JAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC II, SAP
Contact information
Practice address
131 MENLO DR N, KEIZER, OR 97303-5534
(503) 304-4358
(503) 304-4361
Mailing address
9400 SE THREE TREES LN, AMITY, OR 97101-2142
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02-R-32
OR
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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