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Irvin D Wilson, CADCI
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1952931776

Irvin D Wilson is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Irvin D Wilson practices in Portland, OR and has the professional credentials of CADCI. The NPI Number for Irvin D Wilson is 1952931776 and holds a License No. 20-11-14 (Oregon).

The current practice location address for Irvin D Wilson is 17645 Nw Saint Helens Rd, Portland, OR and can be reached out via phone at 503-621-1069 and via fax at 503-621-0200.

Location: 17645 Nw Saint Helens Rd, Portland, OR, 97205-1715
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Provider Profile Details
NPI Number
1952931776
Provider Name
Irvin D Wilson
Credential
CADCI
Provider Entity Type
Individual
Gender
Male
Address
17645 Nw Saint Helens Rd, Portland, OR, 97205-1715
Phone Number
503-621-1069
Fax Number
503-621-0200
Provider Enumeration Date
01/21/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500776112 05 OR
institution
Provider Business Practice Location Address Details
Address
17645 Nw Saint Helens Rd
City
State
Zip
97231-1729
Phone Number
503-621-1069
Fax Number
503-621-0200
person
Provider Business Mailing Address Details
Address
17645 Nw Saint Helens Rd
City
State
Zip
97231-1729
Phone Number
503-621-1069
Fax Number
503-621-0200
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
20-11-14 (Oregon)
Definition
Definition to come...
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