person
Mr. Anthony Douglas Dejesus, SUDPT,CADC-R
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1871140350

Anthony Douglas Dejesus is an Addiction (Substance Use Disorder) Counselor based in Vancouver, OR and is specialized in Addiction (Substance Use Disorder). Anthony Douglas Dejesus practices in Portland, OR and has the professional credentials of SUDPT,CADC-R. The NPI Number for Anthony Douglas Dejesus is 1871140350 and holds a License No. CO60778717 (Oregon).

The current practice location address for Anthony Douglas Dejesus is 12662 Se Stark St, Portland, OR and can be reached out via phone at 503-546-7677 and via fax at 503-517-7768.

Location: 12662 Se Stark St, Portland, OR, 98682-3674
person
Provider Profile Details
NPI Number
1871140350
Provider Name
Anthony Douglas Dejesus
Credential
SUDPT,CADC-R
Provider Entity Type
Individual
Gender
Male
Address
12662 Se Stark St, Portland, OR, 98682-3674
Phone Number
503-546-7677
Fax Number
503-517-7768
Provider Enumeration Date
08/20/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12662 Se Stark St
City
State
Zip
97233-1058
Phone Number
503-546-7677
Fax Number
503-517-7768
person
Provider Business Mailing Address Details
Address
12662 Se Stark St
City
State
Zip
97233-1058
Phone Number
503-546-7677
Fax Number
503-517-7768
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CO60778717 (Washington)
Definition
Definition to come...
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