National Provider Identifier
Laurie Jackson, CADC
Laurie Jackson, CADC is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Portland, OR and a listed phone number of (855) 237-9882.
Source: public NPPES record, last updated December 29, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1124668447
- Provider Type
- Individual
- Primary Specialty
- Addiction (Substance Use Disorder) Counselor
- Enumeration Date
- January 14, 2020
- Last Updated
- December 29, 2021
Practice Location
- 1122 Ne 122Nd Ave Ste A102
- Portland, OR 97230-2082
Phone: (855) 237-9882
Mailing Address
- 11400 Se 90Th Ave Apt 1424
- Happy Valley, OR 97086-2626
Specialties
- Addiction (Substance Use Disorder) Counselor (101YA0400X)
Endpoints
- Portland
Connect Url | Health Information Exchange (Hie) | Other | Portland, OR 97230
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Biography
Laurie Jackson, CADC, is a Portland-based addiction counselor. Her public CMS NPI Registry record lists her CADC credential and identifies addiction counseling as her primary professional focus.
Full Record
- NPI
- 1124668447
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Laurie
- Credential
- CADC
- Provider Other Last Name
- Fortin
- Provider Other First Name
- Tina
- Provider Other Credential Text
- CADC
- Provider Other Last Name Type Code
- 5
- Mailing Street Address
- 11400 Se 90Th Ave Apt 1424
- Mailing City
- Happy Valley
- Mailing State
- OR
- Mailing ZIP Code
- 97086-2626
- Mailing Country
- US
- Mailing Phone
- (503) 607-5791
- Practice Street Address
- 1122 Ne 122Nd Ave Ste A102
- Practice City
- Portland
- Practice State
- OR
- Practice ZIP Code
- 97230-2082
- Practice Country
- US
- Practice Phone
- (855) 237-9882
- Enumeration Date
- January 14, 2020
- Last Updated
- December 29, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- December 29, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Addiction (Substance Use Disorder) Counselor (101YA0400X)