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General NPI Number Information
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NPI Number | 1629584529
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Entity Type | Individual
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Provider Name | MARK ANTHONY RIOUX
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Gender | Male
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 2808 SE BALFOUR ST
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City | MILWAUKIE
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State | OR
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Zip | 97222-6426
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Country | US
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Telephone | 503-659-2575
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Fax | 503-659-5182
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Provider Business Mailing Address
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Address Line | 6601 NE 78TH CT STE A3
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City | PORTLAND
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State | OR
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Zip | 97218-2823
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Country | US
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Telephone | 35-252-3949
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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