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General NPI Number Information
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NPI Number | 1760903959
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Entity Type | Individual
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Provider Name | FAITH HELENE BOLTON CADCII/PSS/CRM/QMHAR
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 17645 NW SAINT HELENS RD
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City | PORTLAND
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State | OR
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Zip | 97231-1729
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Country | US
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Telephone | 503-621-1069
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Fax | 503-621-0200
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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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 | 21-01-20005
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License Number State | OR
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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 | 15-CRM-180
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License Number State | OR
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Taxonomy #3
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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-5226
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | THW000001262
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License Number State | OR
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