Provider Demographics
NPI:1639429137
Name:YOUNG, JANET ELAINE (NCC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ELAINE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-0634
Mailing Address - Country:US
Mailing Address - Phone:503-663-4105
Mailing Address - Fax:
Practice Address - Street 1:32300 SE BLUFF RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-8822
Practice Address - Country:US
Practice Address - Phone:503-663-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health