Provider Demographics
NPI:1215743323
Name:MURRAY, JANESSA RAE-LYNN (CADC-R)
Entity type:Individual
Prefix:MS
First Name:JANESSA
Middle Name:RAE-LYNN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33481 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-8508
Mailing Address - Country:US
Mailing Address - Phone:971-290-8188
Mailing Address - Fax:
Practice Address - Street 1:211 NE 18TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2822
Practice Address - Country:US
Practice Address - Phone:971-232-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-24-4705101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)