Jaclyn Max

Addiction (Substance Use Disorder) Counselor · Gresham, OR

Individual Active NPI

NPI number 1821811225

Practice location

21440 SE Stark St
Gresham, OR 97030-2024
Phone
(971) 427-0466

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NPI record

NPI
1821811225
Entity type
Individual (Type 1)
Enumeration date
November 4, 2024
Last updated
November 4, 2024
Certified
November 4, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X T-24-4370 OR

Mailing address

11010 SE Division St Ste 200
Portland, OR 97266-6400

About Jaclyn Max

Jaclyn Max is a healthcare provider registered in the NPI registry with the primary taxonomy Addiction (Substance Use Disorder) Counselor (code 101YA0400X). The practice location is 21440 SE Stark St, Gresham, OR 97030-2024. The NPI number 1821811225 was assigned on November 4, 2024 and the record was last updated on November 4, 2024.

Jaclyn Max lists a license in the registry: #T-24-4370 (OR) for Addiction (Substance Use Disorder) Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jaclyn Max?

The NPI number is 1821811225.

What is the phone number of Jaclyn Max?

The phone number listed for the practice location is (971) 427-0466.

Where is Jaclyn Max located?

21440 SE Stark St, Gresham, OR 97030-2024.

What is the taxonomy code for Jaclyn Max?

The primary taxonomy code is 101YA0400X – Addiction (Substance Use Disorder) Counselor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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