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General NPI Number Information
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NPI Number | 1457063661
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Entity Type | Individual
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Provider Name | HUSSEIN DAYOW IDOW CSWA
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Gender | Male
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 03/16/2025
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Provider Practice Location Address
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Address Line | 9400 SW BEAVERTON HILLSDALE HWY STE 250
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City | BEAVERTON
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State | OR
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Zip | 97005-3300
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Country | US
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Telephone | 971-266-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 35 NE 148TH AVE APT 326
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City | PORTLAND
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State | OR
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Zip | 97230-4258
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Country | US
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Telephone | 503-676-9224
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Fax |
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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 | T-22-2133
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 24-QMHA-R-5932
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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