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General NPI Number Information
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NPI Number | 1013331065
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Entity Type | Individual
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Provider Name | BRET MARKUS OLSEN CADC I
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Gender | Male
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 9450 SW COMMERCE CIR
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City | WILSONVILLE
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State | OR
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Zip | 97070-8855
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Country | US
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Telephone | 503-682-7744
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Fax | 503-682-3384
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Provider Business Mailing Address
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Address Line | 9450 SW COMMERCE CIR STE 312
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City | WILSONVILLE
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State | OR
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Zip | 97070-8858
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Country | US
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Telephone | 503-682-7744
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Fax | 503-682-3384
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13-12-32
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License Number State | OR
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