Jason Sommerfeldt
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Shedd, OR
NPI 1013765015 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1013765015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 31700 Fayetteville Dr
Shedd, OR 97377-9779 - Phone
- (503) 208-9004
- NPI assigned
- May 7, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teen Challenge International Pacific Northwest Centers | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
18600 SE McLoughlin Blvd
Portland, OR 97267
Phone (855) 932-3852
31700 Fayetteville Dr
Shedd, OR 97377
Phone (503) 208-9004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
31700 Fayetteville Dr
Shedd, OR 97377-9779
Mailing address
18600 SE McLoughlin Blvd
Milwaukie, OR 97267-6723
Phone (503) 946-3267
Other providers in Shedd, OR
- Monty Dale Meyer
- Heather Elaine Miller
- Rudy Rodriguez
- Savannah Rose
- Kyra Ginee Rund
- Fiona Willow Stewart
- Travis Sturholm
All providers in Shedd, OR · Addiction (Substance Use Disorder) Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.