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Individual

JENNY LYNN IREDALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CP 61190077

Contact information

Practice address
825 E 5TH ST, PORT ANGELES, WA 98362-3818
(360) 477-4790
(360) 477-4798
Mailing address
825 E 5TH ST, PORT ANGELES, WA 98362-3818
(360) 477-4790
(360) 477-4798

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
60969949
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61190077
WA

Other

Enumeration date
05/16/2020
Last updated
11/03/2022
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