JACOB O JOHNSON

GRESHAM, OR
NPI1669399903
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-25-5918)
Enumeration Date2026-06-29
Last Update Date2026-06-29
Business Address
JACOB O JOHNSON
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030-5770
Phone number: 503-740-1971
Mailing Address
JACOB O JOHNSON
17893 SW NELS DR
SHERWOOD, OR 97140-8079
Phone number: 503-332-9041
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