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DEFORREST KWESI JACKSON CADC-1
NPI 1194356618
Counselor - Addiction (Substance Use Disorder) in Portland, OR

Active since February 03, 2020
12670 NW BARNES RD STE 200, PORTLAND, OR 97229(971) 232-3850 Get Directions Write a Review

NPPES record last updated: March 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 3, 2022, Feb 3, 2020 (2 updates tracked since 2020).

About Deforrest Kwesi Jackson Cadc-1 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEFORREST KWESI JACKSON CADC-1 (NPI 1194356618) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (T-20-047) and active in the NPI registry since February 2020.

NPPES Registry Identity

NPI1194356618
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameDEFORREST KWESI JACKSONCredential: CADC-1
Location Address12670 NW BARNES RD STE 200Portland, OR 97229-9001
Mailing Address11400 Se 90th Ave Apt 1424Happy Valley, OR 97086-2626 · (503) 432-7975
Phone(971) 232-3850
Sole ProprietorNo
Enumeration DateFebruary 3, 2020
Last NPPES UpdateMarch 3, 20222 updates tracked since enumeration
NPPES CertifiedMarch 3, 2022
✔ NPI 1194356618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OR · T-20-047
12670 NW BARNES RD STE 200, Portland, OR 97229
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONSTANTINE ZIGMUND GOLDSTEIN CADC-R
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (443) 589-4195
CARRIE AGEE CADC-R
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (503) 747-0404
KIRSTINA MARIE MORGAN
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (971) 213-7222
ALARIC TIEN DINH
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (503) 747-0404
TONY JAMES VEZINA BSW, CRM, PSS, CADC
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (971) 248-8899
RYAN MCCAFFREY
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (971) 272-8263
JOHN THOMAS BRISTOL CADC-I, CRM
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (971) 232-3850
DANIEL GREGG VANDAAM
Counselor (Addiction (Substance Use Disorder))
12670 NW BARNES RD STE 200
PORTLAND, OR 97229
Washington County (971) 213-7222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deforrest Jackson's NPI number?

The NPI number for Deforrest Jackson is 1194356618. It was assigned to this individual provider in the NPPES registry on February 3, 2020.

Where is Deforrest Jackson located?

Deforrest Jackson practices at 12670 NW Barnes Rd Ste 200, Portland, OR 97229. The listed phone number is (971) 232-3850.

What is Deforrest Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Deforrest Jackson was last updated on March 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.