Provider Demographics
NPI:1821867458
Name:JONES, ZACHARY OSBORN (CRM, CADC-R, CPR/AED)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:OSBORN
Last Name:JONES
Suffix:
Gender:M
Credentials:CRM, CADC-R, CPR/AED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 NE MARTIN LUTHER KING BLVD APT 211
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3094
Mailing Address - Country:US
Mailing Address - Phone:503-488-0256
Mailing Address - Fax:
Practice Address - Street 1:3035 NE MARTIN LUTHER KING BLVD APT 211
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3094
Practice Address - Country:US
Practice Address - Phone:503-488-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-23-2741101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)