William James Bradford, CADC INTERN

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

NPI 1376748798 · NPPES record last updated Nov 8, 2007

Key facts

NPI
1376748798
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
PRE-CADC INTERN (OR)
Practice address
2415 SE 43Rd Ave
Suite 200
Portland, OR 97206-1600
Phone
(503) 872-0187
NPI assigned
Jun 16, 2007
Sex
Male
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
PRE-CADC INTERNORMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Addiction (Substance Use Disorder) Counselor 101YA0400X PRE-CADC INTERN OR Yes

Addresses

Primary practice location

2415 SE 43Rd Ave
Suite 200
Portland, OR 97206-1600

Mailing address

768 SE 193Rd Ave
Apt. C-316
Portland, OR 97233-5784
Phone (503) 674-4941

Other providers in Portland, OR

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

Sources for this page

Verify at the official NPI Registry.