Provider Demographics
NPI:1184596611
Name:PARKER, JACKSON HENRY (MSW)
Entity type:Individual
Prefix:MR
First Name:JACKSON
Middle Name:HENRY
Last Name:PARKER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14389 S MAPLELANE RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8883
Mailing Address - Country:US
Mailing Address - Phone:503-266-3050
Mailing Address - Fax:
Practice Address - Street 1:22518 S PARROT CREEK RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-9725
Practice Address - Country:US
Practice Address - Phone:503-266-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical