MR. Jacob Carlisle Hostetter, CLINICAL COUNSELOR

NPI #1386187276 in Dallas, Oregon

Provider Information

NPI Number: 1386187276
Entity Type: Individual
Name: MR. Jacob Carlisle Hostetter, CLINICAL COUNSELOR
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: CLINICAL COUNSELOR
Enumeration Date: Nov 23, 2016
Last Updated: Sep 25, 2019

Practice Location

Address: 182 SW ACADEMY ST
City: Dallas
State: Oregon
ZIP Code: 97338-1996
Phone: (503) 623-9289

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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