Provider Demographics
NPI:1669738589
Name:DZAFIC, JASMINA (MA, CADC I CANDIDATE)
Entity type:Individual
Prefix:
First Name:JASMINA
Middle Name:
Last Name:DZAFIC
Suffix:
Gender:F
Credentials:MA, CADC I CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 NE KELLY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5629
Mailing Address - Country:US
Mailing Address - Phone:503-258-4615
Mailing Address - Fax:
Practice Address - Street 1:912 NE KELLY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5629
Practice Address - Country:US
Practice Address - Phone:503-258-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)