Individual provider · Type 1 NPI

Brian Paul Mayta, CADC I

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1114063476 Active

Practice location

847 NE 19th Ave Ste 100
Portland, OR 97232-2684

Call (503) 238-0769 Map

Mailing address

PO Box 8459, 847 NE 19th Av. Suite 100
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X05-03-29 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1114063476

Brian Paul Mayta, CADC I's National Provider Identifier is 1114063476, issued on Jan 30, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Jun 27, 2016.