JESSE WAYNE COBURN CSWA CADC II QMHP NPI 1902463086

NPI Information

NPI: 1902463086
Provider Name: JESSE WAYNE COBURN, CSWA, CADC II, QMHP
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1122 NE 122ND AVE STE A200
PORTLAND, OR
ZIP 97230
Phone: (503) 594-4766
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Jesse Wayne Coburn, CSWA, CADC II, QMHP is a mental health counselor in Portland, OR. Jesse Wayne Coburn, CSWA, CADC II, QMHP NPI is 1902463086. 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:

1122 NE 122ND AVE STE A200
PORTLAND, OR
ZIP 97230-083
Phone: (503) 594-4766

The enumeration date for this NPI number is 5/23/2019 and was last updated on 8/20/2020.

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)			No
2	101YM0800X	Counselor	Mental Health	A5574	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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