Healthcare Provider Details

I. General information

NPI: 1518095553
Provider Name (Legal Business Name): CASEY FRANCES ZIMMERLEE CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 SE 43RD AVE STE 200
PORTLAND OR
97206-1671
US

IV. Provider business mailing address

23900 SE STARK ST APT 125
GRESHAM OR
97030-3194
US

V. Phone/Fax

Practice location:
  • Phone: 503-230-9654
  • Fax:
Mailing address:
  • Phone: 503-661-5352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: