Paul O Nelson, CADC CANDIDATE/QMHP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-18-281 Issued in OR

Practice address

17645 NW Saint Helens Rd
Portland, OR 97231

Phone

(503) 621-1069

Fax

(503) 621-0200

NPI assigned

Oct 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1750752010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19474 SE 38TH WAY",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "97607",
            "telephone_number": "650-430-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17645 NW SAINT HELENS RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97231",
            "telephone_number": "503-621-1069",
            "fax_number": "503-621-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 9th Ave",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944014302",
            "country_code": "US",
            "telephone_number": "415-579-7157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAUL",
        "middle_name": "O",
        "credential": "CADC CANDIDATE/QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF80598",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "56125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-18-281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500746319",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500747233",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew F Nelson
• Miki K Nelson, MD
• Miranda Sofe Nelson, CSWA
• Nicholas B Nelson, MD
• Paesha Kjerstin Nelson, MA, QMHP
• Quinn Nelson
• Ray Nelson, LPC
• Robert J Nelson, LMT
• Robin L Nelson
• Ronn Jeffry Nelson II, PSYD

• 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 Feb 13, 2019; 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.