Healthcare Provider Details

I. General information

NPI: 1871727370
Provider Name (Legal Business Name): ANDREW RANGEL CADC II, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 SW 105TH AVE STE 120
BEAVERTON OR
97008-8800
US

IV. Provider business mailing address

4310 NE KILLINGSWORTH ST.
PORTLAND OR
97208-3007
US

V. Phone/Fax

Practice location:
  • Phone: 971-245-1332
  • Fax:
Mailing address:
  • Phone: 503-535-1150
  • Fax: 503-528-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: