Individual provider · Type 1 NPI

Jacquelyn L. Johnson, CADC II/QMHA-II

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1700400769 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Call (971) 274-3757 Map

Fax (503) 912-5740

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X24-QMHA-II-000217 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X23-05-20274 (OR)

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

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About NPI 1700400769

Jacquelyn L. Johnson, CADC II/QMHA-II's National Provider Identifier is 1700400769, issued on Jun 4, 2020. 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 Mar 11, 2024.