Individual
MS. JALA AKILAH WALEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC II, QMHA
Contact information
Practice address
9268 SE CLINTON ST, PORTLAND, OR 97266-1456
(503) 870-0480
(503) 872-0481
Mailing address
8525 NE GOING PL, PORTLAND, OR 97220-4859
(503) 872-0480
(503) 872-0481
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932230653
—
OR
Enumeration date
03/07/2007
Last updated
02/03/2009
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