Individual
JESSICA MACKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
511 MAIN ST, #201, OREGON CITY, OR 97045-1830
(503) 655-1029
Mailing address
511 MAIN ST, #201, OREGON CITY, OR 97045-1830
(503) 655-1029
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-03-08
OR
101YM0800X
Mental Health Counselor
R4284
OR
Other
Enumeration date
06/01/2016
Last updated
05/01/2017
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