Individual
MR. CHAD CHRISTOPHER JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, LPC
Contact information
Practice address
9755 SW BARNES RD STE 650, PORTLAND, OR 97225-6657
(503) 444-4862
(503) 648-0755
Mailing address
710 NW AUTUMNCREEK WAY, #L305, BEAVERTON, OR 97006-9008
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3741
LA
101Y00000X
Counselor
Primary
C2925
OR
Other
Enumeration date
07/30/2013
Last updated
12/29/2023
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