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Mr. Leonard Clark, CERTIFIEDALCOHOL&
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1518226216

Leonard Clark is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Leonard Clark practices in Portland, OR and has the professional credentials of CERTIFIEDALCOHOL&. The NPI Number for Leonard Clark is 1518226216 and holds a License No. (Oregon).

The current practice location address for Leonard Clark is 4134 N. Vancouver Ave., Suite 303C, Portland, OR and can be reached out via phone at 503-593-7764.

Location: 4134 N. Vancouver Ave., Suite 303C, Portland, OR, 97217-2900
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Provider Profile Details
NPI Number
1518226216
Provider Name
Leonard Clark
Credential
CERTIFIEDALCOHOL&
Provider Entity Type
Individual
Gender
Male
Address
4134 N. Vancouver Ave., Suite 303C, Portland, OR, 97217-2900
Phone Number
503-593-7764
Fax Number
Provider Enumeration Date
05/15/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06-R-06 01 OR CADC II
institution
Provider Business Practice Location Address Details
Address
4134 N. Vancouver Ave., Suite 303C
City
State
Zip
97217-2900
Phone Number
503-593-7764
Fax Number
person
Provider Business Mailing Address Details
Address
4134 N. Vancouver Ave., Suite 303C
City
State
Zip
97217-2900
Phone Number
503-593-7764
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
(Oregon)
Definition
Definition to come...
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