Provider Demographics
NPI:1316003346
Name:KUTTNER, JASON (LPC, LMHC, CADCIII)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KUTTNER
Suffix:
Gender:M
Credentials:LPC, LMHC, CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1824
Mailing Address - Country:US
Mailing Address - Phone:503-655-8558
Mailing Address - Fax:503-655-8197
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PW76827101YM0800X
HIMHC-677101YM0800X
ORC2140101YM0800X
OR10-R-13101YA0400X
VA0701012405101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)