Individual
BRET D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
(503) 622-8964
Mailing address
905 SE 14TH AVE, PORTLAND, OR 97214-2569
(503) 622-8964
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
07/15/2025
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