Individual provider · Type 1 NPI

Jack Bouba

Counselor · Portland, OR

NPI number 1891589644 Active

Practice location

18417 SE Oak St
Portland, OR 97233-4850

Call (971) 727-8026 Map

Mailing address

5415 SW Westgate Dr
Portland, OR 97221-2409

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1891589644

Jack Bouba's National Provider Identifier is 1891589644, issued on Apr 7, 2025. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Portland, OR. The record was last updated on Apr 7, 2025.