Nicole Jackson
Nicole Jackson is a Community/Behavioral Health Agency in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2025.
- Licensed in
- OR
- In the registry since
- 2025
- Specialties on file
- 3
Practice location Address checks out
8355 N Interstate AvePortland, OR 97217-6716
Phone: (503) 568-1408
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 105324 (OR) |
|---|---|
| Community/Behavioral Health Agency | Taxonomy 251S00000X · Licence 25-QMHA-R-6774 (OR) |
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence T-25-5762 (OR) |
Record details
| NPI number | 1063390870 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | August 21, 2025 |
| Last updated in NPPES | October 3, 2025 |
| Certification date | October 3, 2025 |
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