IndividualActive
Justin Jacobs
NPI 1801522420 · Psychologist · Clackamas, OR
Provider details
- NPI number
- 1801522420
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Case Manager/Care Coordinator171M00000X
Other Service Providers
Practice location
10151 Se Sunnyside Rd Ste 480
Clackamas, OR 97015-5705
Phone: (971) 915-0046
Approximate (ZIP-level) locationGet directions
Mailing address
10151 Se Sunnyside Rd Ste 480
Clackamas, OR 97015-5705
Registry dates
- Enumerated
- 2022-07-26
- Last updated
- 2024-11-29
- Certified
- 2024-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.