Individual
MS. JAMIE MAZHNIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
1316 SE 12TH AVE, PORTLAND, OR 97214-3604
(503) 897-1916
Mailing address
1316 SE 12TH AVE, PORTLAND, OR 97214-3604
(503) 897-1916
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-20-412
OR
101YM0800X
Mental Health Counselor
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-20-412
MHACBO
OR
Enumeration date
01/20/2021
Last updated
12/11/2025
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