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Individual

JARED E JUETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1813 W HARVARD AVENUE, SUITE 201, ROSEBURG, OR 97471-2754
(541) 440-6390
(541) 440-6392
Mailing address
PO BOX 1023, ROSEBURG, OR 97470-0232
(541) 440-6390
(541) 440-6392

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3946
OR
1041C0700X
Clinical Social Worker
Primary
L3946
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500688305
OR
Enumeration date
04/20/2007
Last updated
10/05/2015
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