Individual
JENNIFER M WAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC, LMHC, SUDP
Contact information
Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684
(360) 896-4460
(360) 896-4478
Mailing address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 896-4460
(360) 896-4478
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006159
WA
101YM0800X
Mental Health Counselor
LH00009179
WA
Other
Enumeration date
12/13/2006
Last updated
12/21/2021
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