Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack R Agen, MA

Individual provider Professional Counselor · NPI 1902960362

Jack R Agen, MA is a Mental Health Counselor in Gladstone, Oregon. Qualified in 1993, 33 years ago. Licensed in Oregon.

Years since qualifying
33
Licensed in
OR
In the registry since
2006
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

880 82nd Dr
Gladstone, OR 97027-1803
Phone: (503) 659-5515
Fax: (503) 659-1994
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence C1077 (OR)

Record details

NPI number1902960362
Entity typeIndividual (Type 1)
GenderMale
Credentials MA
Sole proprietorNo
NPI enumeratedDecember 20, 2006
Last updated in NPPESJuly 9, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Gladstone