LAURIE JACKSON

PORTLAND, OR
NPI1124668447
Other NameTINA FORTIN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-01-14
Last Update Date2021-12-29
Business Address
LAURIE JACKSON CADC
1122 NE 122ND AVE STE A102
PORTLAND, OR 97230-2082
Phone number: 855-237-9882
Mailing Address
LAURIE JACKSON CADC
11400 SE 90TH AVE APT 1424
HAPPY VALLEY, OR 97086-2626
Phone number: 503-607-5791
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