Individual provider · Type 1 NPI

Laurie Jackson, CADC

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1124668447 Active

Practice location

1122 NE 122nd Ave Ste A102
Portland, OR 97230-2082

Call (855) 237-9882 Map

Mailing address

11400 SE 90th Ave Apt 1424
Happy Valley, OR 97086-2626

Other practice locations

  • 232 NW 6th Ave, Portland, OR 97209-3609 · (503) 294-1681

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1124668447

Laurie Jackson, CADC's National Provider Identifier is 1124668447, issued on Jan 14, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Dec 29, 2021.