Individual provider · Type 1 NPI

Blake Anthony Davidson

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1295678316 Active

Practice location

1839 NE Glisan St
Portland, OR 97232-2844

Call (503) 963-7676 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1295678316

Blake Anthony Davidson's National Provider Identifier is 1295678316, issued on Apr 13, 2026. 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 Apr 13, 2026.