Individual provider · Type 1 NPI

Shanna Marie Pickens, CDAC-III QMHA-R CRM

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1669949640 Active

Practice location

1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770

Fax (503) 771-2436

Mailing address

10117 SE Sunnyside Rd # F1217
Clackamas, OR 97015-7708

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000X26-CRM-5622 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X26-10-30237 (OR)
Mental Health Counselor 101YM0800X26-QMHA-R-9163 (OR)

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

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About NPI 1669949640

Shanna Marie Pickens, CDAC-III QMHA-R CRM's National Provider Identifier is 1669949640, issued on Oct 29, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Nov 1, 2026.