Individual provider · Type 1 NPI

Mike C. Theodore, QMHA

Addiction (Substance Use Disorder) Counselor · Beaverton, OR

NPI number 1316644735 Active

Practice location

17933 NW Evergreen Pkwy Ste 111
Beaverton, OR 97006-7452

Call (814) 243-0414 Map

Fax (814) 479-5906

Mailing address

3159 Carpenters Park Rd
Davidsville, PA 15928-9223

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X35007 (NY)

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

Other addiction (substance use disorder) counselor providers in Beaverton

See all in Beaverton →

About NPI 1316644735

Mike C. Theodore, QMHA's National Provider Identifier is 1316644735, issued on Feb 15, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Beaverton, OR. The record was last updated on Feb 15, 2023.