Individual provider · Type 1 NPI

Theodore Lee Pearson Iii, CADC I

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1508591637 Active

Practice location

1122 NE 122nd Ave # 200
Portland, OR 97230-2081

Call (503) 732-6653 Map

Mailing address

PO Box 1038
West Tisbury, MA 02575-1038

Other practice locations

  • 111 Edgartown Rd, Vineyard Haven, MA 02568 · (508) 693-7900

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X20-05-10416 (OR)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Other student in an organized health care education/training program providers in Portland

See all in Portland →

About NPI 1508591637

Theodore Lee Pearson Iii, CADC I's National Provider Identifier is 1508591637, issued on Jul 21, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Sep 26, 2023.