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

Jesse Wayne Coburn, LSCW, CADCII, SUDP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1902463086

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 201
Portland, OR 97211-3283
Phone: (503) 954-2077
Fax: (503) 954-2089
Show map & directions

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 number1902463086
Entity typeIndividual (Type 1)
GenderMale
Credentials LSCW , CADCII , SUDP
Sole proprietorYes
NPI enumeratedMay 23, 2019
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026

Other providers in Portland