Individual provider · Type 1 NPI

Jake Sullivan

Mental Health Counselor · Portland, OR

NPI number 1215754387 Active

Practice location

1235 SE Morrison St
Portland, OR 97214-2462

Call (503) 746-3373 Map

Mailing address

7346 NE Sandy Blvd
Portland, OR 97213-5775

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1215754387

Jake Sullivan's National Provider Identifier is 1215754387, issued on Sep 20, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Jun 19, 2026.