Individual
JACLYN KAHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CADC I
Contact information
Practice address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Mailing address
1411 NE 16TH AVE, 215, PORTLAND, OR 97232-4407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/27/2015
Last updated
08/27/2015
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