Individual provider · Type 1 NPI

Jason Cornutt

Peer Specialist · Roseburg, OR

NPI number 1669205159 Active

Practice location

621 W Madrone St
Roseburg, OR 97470-3090

Call (541) 672-2691 Map

Mailing address

PO Box 1121
Roseburg, OR 97470-0254

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Peer Specialist Primary 175T00000X23-CRM-2530 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1669205159

Jason Cornutt's National Provider Identifier is 1669205159, issued on Aug 21, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Roseburg, OR. The record was last updated on Jan 8, 2026.