Provider Demographics
NPI:1053606731
Name:GIEBER, JON STEVEN (CADC II, MS)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:STEVEN
Last Name:GIEBER
Suffix:
Gender:M
Credentials:CADC II, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24205 NE ALVAS RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9646
Mailing Address - Country:US
Mailing Address - Phone:503-740-9478
Mailing Address - Fax:
Practice Address - Street 1:1923 NE BROADWAY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1501
Practice Address - Country:US
Practice Address - Phone:503-740-9478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR84-10-04101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)