Provider Demographics
NPI:1790145928
Name:SALCIDO GILES, JACLYN LEIGH (CADC I, QMHA)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:LEIGH
Last Name:SALCIDO GILES
Suffix:
Gender:F
Credentials:CADC I, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 COLLEGE ST S APT 5
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:OR
Mailing Address - Zip Code:97361-2052
Mailing Address - Country:US
Mailing Address - Phone:503-917-9644
Mailing Address - Fax:
Practice Address - Street 1:306 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4543
Practice Address - Country:US
Practice Address - Phone:541-753-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)