Individual
JENNIFER GOMOLL DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC
Contact information
Practice address
3519 NE 15TH, SUITE 547, PORTLAND, OR 97212
(503) 750-7436
(503) 926-9182
Mailing address
3519 NE 15TH, SUITE 547, PORTLAND, OR 97212
(360) 226-4827
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
60638897
WA
101YP2500X
Professional Counselor
Primary
C1929
OR
Other
Enumeration date
02/27/2007
Last updated
10/07/2024
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