Individual
JENNIFER LIANA SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-2
Contact information
Practice address
1500 NW BETHANY BLVD STE 320, BEAVERTON, OR 97006-5238
(503) 567-3260
Mailing address
1500 NW BETHANY BLVD STE 320, BEAVERTON, OR 97006-5238
(503) 567-3260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-02-10336
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
24-04-20412
OR
405300000X
Prevention Professional
THW000003996
OR
Other
Enumeration date
01/09/2020
Last updated
06/13/2024
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