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General NPI Number Information
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NPI Number | 1548327505
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Entity Type | Individual
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Provider Name | JACQUELINE CARA HADDON LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 821 SAGINAW STREET SOUTH
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City | SALEM
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State | OR
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Zip | 97302
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Country | US
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Telephone | 503-362-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 NE 11TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-4209
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Country | US
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Telephone | 503-267-3708
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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