| Jack R Agen, MA | |
|
880 82nd Dr, Gladstone, OR 97027-1803 | |
| (503) 659-5515 | |
| (503) 659-1994 |
| Full Name | Jack R Agen |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 880 82nd Dr, Gladstone, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902960362 | NPI | - | NPPES |
| 164936 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C1077 (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack R Agen, MA Po Box 82819, Portland, OR 97282-0819 Ph: (503) 233-5405 | Jack R Agen, MA 880 82nd Dr, Gladstone, OR 97027-1803 Ph: (503) 659-5515 |
Sara Padilla, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 880 82nd Dr Bldg A, Gladstone, OR 97027 Phone: 503-902-6430 Fax: 503-659-1994 | |
Mr. Chase S Melby, Counselor Medicare: Not Enrolled in Medicare Practice Location: 870 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 | |
Joni Casterline, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 890 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 | |
Ms. Karen Maline Mindt Howell, LPC Counselor Medicare: Medicare Enrolled Practice Location: 250 Princeton Ave Ste 207, Gladstone, OR 97027 Phone: 503-545-7541 Fax: 503-545-7541 | |
Brian J Hanni, LPC Counselor Medicare: Medicare Enrolled Practice Location: 890 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 | |
Ms. Barbara Collins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 880 82nd Dr, Annex A, Gladstone, OR 97027 Phone: 503-659-5515 Fax: 503-210-2475 | |
Daniel Hazen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18000 Webster Rd, Gladstone, OR 97027 Phone: 503-722-4470 |