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Individual

JEAN A DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, PMHNP-BC

Contact information

Practice address
3439 NE SANDY BLVD, PMB 375, PORTLAND, OR 97232-1959
(503) 284-8841
Mailing address
9155 SW BARNES RD, SUITE 418, PORTLAND, OR 97225-6625
(971) 270-0995
(503) 292-4570

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L3975
OR
163W00000X
Registered Nurse
201142799RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201391588NP-PP
OR

Other

Enumeration date
03/05/2007
Last updated
10/24/2016
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