person
Frederick Douglass Staten, PHD,LPC,CRC,CADC
Professional Counselor in Portland, Oregon
NPI 1417216730

Frederick Douglass Staten is a Professional Counselor based in Portland, OR and is specialized in Professional. Frederick Douglass Staten practices in Portland, OR and has the professional credentials of PHD,LPC,CRC,CADC. The NPI Number for Frederick Douglass Staten is 1417216730 and holds a License No. (Oregon).

The current practice location address for Frederick Douglass Staten is 2415 Se 43Rd Ave Ste 100, Portland, OR and can be reached out via phone at 503-230-9654 and via fax at 503-236-7166.

Location: 2415 Se 43Rd Ave Ste 100, Portland, OR, 97207-8459
person
Provider Profile Details
NPI Number
1417216730
Provider Name
Frederick Douglass Staten
Credential
PHD,LPC,CRC,CADC
Provider Entity Type
Individual
Gender
Male
Address
2415 Se 43Rd Ave Ste 100, Portland, OR, 97207-8459
Phone Number
503-230-9654
Fax Number
503-236-7166
Provider Enumeration Date
05/07/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2415 Se 43Rd Ave Ste 100
City
State
Zip
97206-1666
Phone Number
503-230-9654
Fax Number
503-236-7166
person
Provider Business Mailing Address Details
Address
2415 Se 43Rd Ave Ste 100
City
State
Zip
97206-1666
Phone Number
503-230-9654
Fax Number
503-236-7166
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
C2994 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
()
Definition
Definition to come...
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