MEDICARE: JASON BRETT LEWIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	T-25-6168	OR

General Provider Information

NPI Number	:	1073716890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON BRETT LEWIS

Provider Business Mailing Address
First Line	:	213 WATER AVE NW
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-2298
Country	:	US
Telephone Number	:	541-730-4123
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 WATER AVE NW
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-2298
Country	:	US
Telephone Number	:	541-730-4123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	01/12/2026

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Directions to “ JASON BRETT LEWIS ” Practice Location

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