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NPI Code Detail

MEDICARE: TERAS INTERVENTIONS AND COUNSELING

MEDICARE: TERAS INTERVENTIONS AND COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184917783
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERAS INTERVENTIONS AND COUNSELING
Provider Business Mailing Address
First Line : 3945 SE HAWTHORNE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97214-5241
Country : US
Telephone Number : 503-719-5250
Fax Number :
Provider Business Practice Location Address
First Line : 3945 SE HAWTHORNE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97214-5241
Country : US
Telephone Number : 503-719-5250
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. PHILLIP BROYLES
Credential : BS,CADCII
Telephone Number : 503-719-5250
Provider Enumeration Date : 05/16/2011
Last Update Date : 11/08/2013

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1619519576 — ERIKA LYNN BUDD CADCII, QMHA
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Directions to “TERAS INTERVENTIONS AND COUNSELING ” Practice Location

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