Individual
JENNIFER L CHESHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP,CADCIII
Contact information
Practice address
15520 NE 82ND CIR, VANCOUVER, WA 98682-3745
(360) 608-6887
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
(503) 233-2696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
05-11-93
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00004411
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
12/20/2006
Last updated
03/10/2010
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