Individual
CARLOS JORGE VAZQUEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC,CGAC,QMHA,CRM
Contact information
Practice address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Mailing address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
G-24-05-1018
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23-06-20284
OR
101YM0800X
Mental Health Counselor
25-QMHA-II-000461
OR
175T00000X
Peer Specialist
21-CRM-704
OR
175T00000X
Peer Specialist
23-CGRM-020
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-CRM-704
MHACBO CRM
OR
01
—
23-06-20284
MHACBO CADC-II
OR
01
—
23-CGRM-020
MHACBO CGRM
OR
01
—
25-QMHA-II-000461
MHACBO-QMHA-II
OR
05
—
500732064
—
OR
01
—
G-24-05-1018
MHACBO CGAC-I
OR
Enumeration date
02/15/2017
Last updated
01/07/2026
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