Jesse Wayne Coburn, LSCW, CADCII, SUDP
Jesse Wayne Coburn, LSCW, CADCII, SUDP is an Addiction (Substance Use Disorder) Counselor in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon and Washington.
- Licensed in
- OR, WA
- In the registry since
- 2019
- Specialties on file
- 5
Practice location Address checks out
5257 NE Mlk Jr Blvd Ste 201Portland, OR 97211-3283
Phone: (503) 954-2077
Fax: (503) 954-2089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence LW61327515 (WA) |
|---|---|
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence 19-10-32 (OR) |
| Clinical Social Worker | Taxonomy 1041C0700X · Licence L10830 (OR) |
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence CP61374175 (WA) |
| Clinical Social Worker | Taxonomy 1041C0700X · Licence L18030 (OR) |
Record details
| NPI number | 1902463086 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LSCW , CADCII , SUDP |
| Sole proprietor | Yes |
| NPI enumerated | May 23, 2019 |
| Last updated in NPPES | June 24, 2026 |
| Certification date | June 24, 2026 |
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