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

Jacob O Johnson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1669399903

Jacob O Johnson is an Addiction (Substance Use Disorder) Counselor in Gresham, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770
Phone: (503) 740-1971
Fax: (503) 771-2436
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence T-25-5918 (OR)

Record details

NPI number1669399903
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 29, 2026
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026
Mailing address17893 Sw Nels Dr, Sherwood, OR 97140-8079

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