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General NPI Number Information
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NPI Number | 1497733596
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Entity Type | Individual
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Provider Name | JAN SNYDER ALEXANDER LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 11/20/2016
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Provider Practice Location Address
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Address Line | 1210 SE OAK ST SUITE 5
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City | PORTLAND
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State | OR
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Zip | 97214-1427
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Country | US
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Telephone | 503-804-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 28 SE 28TH AVENUE CONDO 202
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 503-804-1627
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L5192
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License Number State | OR
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