Active NPI
Jessica Carmen Harrison, BS, CADC I
- Case Manager/Care Coordinator
- Portland, OR
National Provider Identifier
1417094129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 9268 SE Clinton St
Portland, OR 97266-1456 - Phone
- (503) 872-0480
- Fax
- (503) 872-0481
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | QMHA | OR | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 105-11-25 | OR | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
9268 SE Clinton St
Portland, OR 97266-1456
Mailing address
2830 SE 127TH Ave
A233
Portland, OR 97236-3183
Phone (503) 872-0480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| QMHA | OR | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1417094129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2830 SE 127TH AVE",
"address_2": "A233",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363183",
"telephone_number": "503-872-0480",
"fax_number": "503-872-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9268 SE CLINTON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972661456",
"telephone_number": "503-872-0480",
"fax_number": "503-872-0481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "JESSICA",
"middle_name": "CARMEN",
"credential": "BS, CADC I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "QMHA",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "105-11-25",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.