Individual
JESSICA LEE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CACD-R
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(503) 505-2925
Mailing address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(503) 505-2925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2940
OR
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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