Molly C Bair, CADCII,

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Gladstone, OR

NPI 1285798660 · NPPES record last updated Jun 11, 2008

Key facts

NPI
1285798660
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
04-R-13 (OR)
Practice address
880 82ND Dr
Gladstone, OR 97027-1803
Phone
(503) 659-5515
Fax
(503) 659-1994
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
04-R-13ORMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 04-R-13 OR Yes

Addresses

Primary practice location

880 82ND Dr
Gladstone, OR 97027-1803

Mailing address

PO Box 82819
Portland, OR 97282-0819
Phone (503) 233-5405

Other identifiers

IdentifierTypeStateIssuer
164936MedicaidOR

Other providers in Gladstone, OR

All providers in Gladstone, OR · Addiction (Substance Use Disorder) Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.