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.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.