Individual provider · Type 1 NPI

Jesse N. Spain, CADC II/QMHA-I

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1477911477 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Call (971) 274-3757 Map

Fax (503) 912-5740

Mailing address

12104 SE Tibbetts St
Portland, OR 97266-1049

Other practice locations

  • 1631 SW Columbia St, Portland, OR 97201-6025 · (503) 231-2641
  • 1776 SW Madison St, Portland, OR 97205-1715 · (503) 224-1044
  • 17645 NW Saint Helens Rd, Portland, OR 97231-1729 · (503) 621-1069

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X15-01-09 (OR)
Mental Health Counselor 101YM0800X19-QMHA-I-00297 (OR)
Mental Health Counselor 101YM0800XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X17-04-13 (OR)

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

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About NPI 1477911477

Jesse N. Spain, CADC II/QMHA-I's National Provider Identifier is 1477911477, issued on Feb 4, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Jul 11, 2019.