Jack R Agen is a Gladstone, Oregon based counselor who is specialized as Professional Counselor. Active license number of Jack R Agen is C1077 for Professional Counselor in Oregon. His current practice location is 880 82nd Dr, Gladstone. Patients can book an appointment with him at 503-659-5515.
Jack R Agen is a licensed mental health practitioner trained to help individuals, couples, and groups address emotional, psychological, and behavioral challenges. He uses talk therapy and evidence-based counseling methods to support clients in managing mental health conditions, improving relationships, and developing coping strategies for life’s difficulties.
Complete Profile:
Jack R Agen speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Jack R Agen
Specialization:
Professional Counselor
Gender:
Male
Credentials:
MA
Accepts Medicare Assignment:
No
Practice Address:
880 82nd Dr, Gladstone, Oregon, 97027-1803
Phone:
503-659-5515
Fax:
503-659-1994
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1902960362
NPI Enumeration Date:
20 Dec, 2006
NPI Last Update On:
09 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jack R Agen are as mentioned below.
License Number
Specialization
State
Status
C1077
Professional Counselor
Oregon
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Jack R Agen such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
164936
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Po Box 82819, Portland, Oregon
Zip:
97282-0819
Phone Number:
503-233-5405
Fax Number:
503-233-2696
Patients can reach Jack R Agen at 880 82nd Dr, Gladstone, Oregon or can call to book an appointment on 503-659-5515. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 July, 2025.