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Paul Modesitt, CADC1
Peer Specialist in Oregon City, Oregon
NPI 1699276550

Paul Modesitt is a Peer Specialist based in Oregon City, OR. Paul Modesitt practices in Oregon City, OR and has the professional credentials of CADC1. The NPI Number for Paul Modesitt is 1699276550 and holds a License No. (Oregon).

The current practice location address for Paul Modesitt is 900 Main St Ste 200, Oregon City, OR and can be reached out via phone at 971-386-3401 and via fax at 503-723-6653. You can also correspond with Paul Modesitt through the mailing address at 706 MAIN ST, OREGON CITY, OR - 97045-1815 (mailing address contact number: 503-655-1029).

Location: 900 Main St Ste 200, Oregon City, OR, 97045-1815
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699276550
Provider Name
Paul Modesitt
Credential
CADC1
Provider Entity Type
Individual
Gender
Male
Address
900 Main St Ste 200, Oregon City, OR, 97045-1815
Phone Number
971-386-3401
Fax Number
503-723-6653
Provider Enumeration Date
02/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
900 Main St Ste 200
City
Oregon City
State
Oregon
Zip
97045-1869
Phone Number
971-386-3401
Fax Number
503-723-6653
person
Provider Business Mailing Address Details
Address
900 Main St Ste 200
City
Oregon City
State
Oregon
Zip
97045-1869
Phone Number
971-386-3401
Fax Number
503-723-6653
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
17-CRM-187 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(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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