Individual
JESSE CARMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM, CADC R
Contact information
Practice address
1501 6TH ST, LA GRANDE, OR 97850-2419
(541) 962-0162
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 429-8844
(541) 429-8822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25-02-11409
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2372
OR
175T00000X
Peer Specialist
23-CRM-1603
OR
Other
Enumeration date
03/01/2023
Last updated
01/22/2026
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