Paul Doug Derham, CADC-R

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

4713 N Albina Ave Ste 301
Portland, OR 97217-2605

Phone

(503) 707-9771

NPI assigned

Aug 28, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1003795618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4713 N ALBINA AVE STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4713 N ALBINA AVE STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172605",
            "telephone_number": "503-707-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERHAM",
        "first_name": "PAUL",
        "middle_name": "DOUG",
        "credential": "CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Deras
• Craig Stuart Derby, MD
• Shannon Derbyshire, DC
• Genevieve N Derenne, OTR
• Ebisa Deressa
• Lila Derickson, ND
• George Derk, MD
• Gwendolyn Rose Derk
• Dermatology by Design LLC
• Dermatology Professionals

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.