Individual
IAN RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(971) 804-0322
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26-03-11846
OR
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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