Individual
JACQUELYN DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, CRC, NCC, LPC
Contact information
Practice address
812 SW WASHINGTON ST STE 700, PORTLAND, OR 97205-3200
(503) 482-9590
Mailing address
7175 SW IVY LN APT 37, PORTLAND, OR 97225-1159
(601) 520-3224
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C7602
OR
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
07/14/2021
Last updated
12/03/2024
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