person
Mr. David Madison Humphries, CADCI/CRMII/PSS
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1184054710

David Madison Humphries is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). David Madison Humphries practices in Portland, OR and has the professional credentials of CADCI/CRMII/PSS. The NPI Number for David Madison Humphries is 1184054710 and holds a License No. 17-CRM-II-011 (Oregon).

The current practice location address for David Madison Humphries is 1631 Sw Columbia St, Portland, OR and can be reached out via phone at 503-231-2641 and via fax at 503-231-1654.

Location: 1631 Sw Columbia St, Portland, OR, 97205-1715
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Provider Profile Details
NPI Number
1184054710
Provider Name
David Madison Humphries
Credential
CADCI/CRMII/PSS
Provider Entity Type
Individual
Gender
Male
Address
1631 Sw Columbia St, Portland, OR, 97205-1715
Phone Number
503-231-2641
Fax Number
503-231-1654
Provider Enumeration Date
11/18/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500730604 05 OR
500699779 05 OR
institution
Provider Business Practice Location Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider Business Mailing Address Details
Address
1631 Sw Columbia St
City
State
Zip
97201-6025
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
THW0001269 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
17-CRM-II-011 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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