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1851602825
JESSICA GRACE BOTT
PORTLAND, OR
NPI
1851602825
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 08-12-04)
Enumeration Date
2010-06-24
Last Update Date
2010-06-28
Business Address
-- JESSICA GRACE BOTT CADCI, QMHA
709 NW EVERETT ST
PORTLAND, OR 97209-3517
Phone number: 503-226-4060
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Mailing Address
-- JESSICA GRACE BOTT CADCI, QMHA
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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