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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

JACOB O JOHNSON
NPI 1669399903
Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Active since June 29, 2026
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030(503) 740-1971(503) 771-2436 Get Directions Write a Review

NPPES record added: June 29, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacob O Johnson NPPES

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

JACOB O JOHNSON (NPI 1669399903) is an individual addiction (substance use disorder) provider in Gresham, Oregon, licensed in Oregon (T-25-5918) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1669399903
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJACOB O JOHNSON
Location Address1217 NE BURNSIDE RD STE 701Gresham, OR 97030-5770
Mailing Address17893 Sw Nels DrSherwood, OR 97140-8079 · (503) 332-9041 · Fax (503) 771-2436
Phone(503) 740-1971
Fax(503) 771-2436
Sole ProprietorYes
Enumeration DateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1669399903 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-25-5918
1217 NE BURNSIDE RD STE 701, Gresham, OR 97030
Open in Google Maps ↗

Other Providers at the Same Location NPPES 16

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

GOLDEN RIBBON ACUPUNCTURE, LLC
Clinic/Center (Health Service)
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 839-5510
GWENDOLYN JOY KOCHAN LMT
Massage Therapist
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 665-8959
SHANNON WELSH CRM, CADC
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 866-0877
SHAILI R PAREKH QMHA
Rehabilitation Practitioner
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
IZABELLA JOHNSON QMHA-SOCIAL WORK
Counselor (Mental Health)
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
EASTON HALLOCK CADC II, QMHA II
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 866-0877
NATHAN KENNELLY CRM, CADC R
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-6449
ELIJAH ANDERSEN CRM
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971

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 Jacob Johnson's NPI number?

The NPI number for Jacob Johnson is 1669399903. It was assigned to this individual provider in the NPPES registry on June 29, 2026.

Where is Jacob Johnson located?

Jacob Johnson practices at 1217 NE Burnside Rd Ste 701, Gresham, OR 97030. The listed phone number is (503) 740-1971.

What is Jacob Johnson'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 Jacob Johnson was last updated on June 29, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.