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COBALT JACE KUBU
NPI 1417835729
Counselor - Mental Health in Portland, OR

Active since August 25, 2025
12511 SE RAYMOND ST, PORTLAND, OR 97236(503) 761-2580(503) 761-2584 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Cobalt Jace Kubu NPPES

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

COBALT JACE KUBU (NPI 1417835729) is an individual mental health provider in Portland, Oregon and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1417835729
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameCOBALT JACE KUBU
Location Address12511 SE RAYMOND STPortland, OR 97236-3931
Mailing Address3587 Heathrow WayMedford, OR 97504-4004 · (541) 858-8170 · Fax (541) 858-8167
Phone(503) 761-2580
Fax(503) 761-2584
Sole ProprietorNo
Enumeration DateAugust 25, 2025
NPPES CertifiedAugust 25, 2025
✔ NPI 1417835729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
12511 SE RAYMOND ST, Portland, OR 97236
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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.

COLUMBIACARE SERVICES
Community Based Residential Treatment Facility, Mental Illness
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
JESSICA CALCAGNI
Social Worker (Clinical)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
BEATRICE OTTI
Social Worker (Clinical)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
JUSTINE CUTHBERTSON
Counselor (Mental Health)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
AMBER PROBERT
Counselor (Mental Health)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
CARRIE EDWARDS
Counselor (Mental Health)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
JULIA EHRLICH
Counselor (Mental Health)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580
DAVID MOORE
Counselor (Mental Health)
12511 SE RAYMOND ST
PORTLAND, OR 97236
Multnomah County (503) 761-2580

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 Cobalt Kubu's NPI number?

The NPI number for Cobalt Kubu is 1417835729. It was assigned to this individual provider in the NPPES registry on August 25, 2025.

Where is Cobalt Kubu located?

Cobalt Kubu practices at 12511 SE Raymond St, Portland, OR 97236. The listed phone number is (503) 761-2580.

What is Cobalt Kubu's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Cobalt Kubu was last updated on August 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.