Individual
MR. MARK WILLIAM DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 517-0878
(503) 517-0866
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-0878
(503) 517-0866
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18-03-14
OR
101YP2500X
Professional Counselor
Primary
C2839
OR
Other
Enumeration date
04/24/2008
Last updated
11/24/2023
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