Healthcare Provider Details

I. General information

NPI: 1932569456
Provider Name (Legal Business Name): DAVID RIHA CADC II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10920 SW BARBUR BLVD
PORTLAND OR
97219-8600
US

IV. Provider business mailing address

10920 SW BARBUR BLVD
PORTLAND OR
97219-8600
US

V. Phone/Fax

Practice location:
  • Phone: 503-244-4500
  • Fax: 503-244-2008
Mailing address:
  • Phone: 503-244-4500
  • Fax: 503-244-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number14-06-15
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: