Provider Demographics
NPI:1972216398
Name:JARAMILLO, RONDA L (CADCR)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:L
Last Name:JARAMILLO
Suffix:
Gender:
Credentials:CADCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 NW DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5436
Mailing Address - Country:US
Mailing Address - Phone:503-816-2953
Mailing Address - Fax:
Practice Address - Street 1:3231 SE 50TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-2248
Practice Address - Country:US
Practice Address - Phone:503-422-5542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)