Organization
OREGON CHANGE CLINIC, LLC
Active
Other names
Oregan Change Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON JONES MS, MFT (OWNER/CEO)
(909) 455-4838
Entity
Organization
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(909) 455-4838
Mailing address
1817 NE 6TH AVENUE, PORTLAND, OR 97212-3906
(503) 719-7985
(503) 944-5262
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
10/17/2020
Last updated
03/06/2026
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