Individual
JENNIFER DODARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17882 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6103
(503) 353-9415
Mailing address
172 NE HAYES ST, HILLSBORO, OR 97124-2356
(503) 353-9415
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-09-09
OR
372600000X
Adult Companion
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292910
—
OR
Enumeration date
09/22/2015
Last updated
01/27/2017
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