MR. JACKIE EUGENE JOHNSON MSW CADC II NPI 1770745457

NPI Information

NPI: 1770745457
Provider Name: MR. JACKIE EUGENE JOHNSON, MSW, CADC II
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1020 SW TAYLOR ST STE 650
PORTLAND, OR
ZIP 97205
Phone: (503) 345-3370
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MR. Jackie Eugene Johnson, MSW, CADC II is an addiction (substance use disorder) counselor in Portland, OR. MR. Jackie Eugene Johnson, MSW, CADC II NPI is 1770745457. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1020 SW TAYLOR ST STE 650
PORTLAND, OR
ZIP 97205-506
Phone: (503) 345-3370
Fax: (503) 926-0348

The enumeration date for this NPI number is 6/25/2008 and was last updated on 7/28/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	00-11-45	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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