Individual
MR. DAVID MADISON HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I/CRM II
Contact information
Practice address
355 NW DIVISION ST, GRESHAM, OR 97030-5523
(971) 225-6695
(503) 231-1654
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-07-06
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
17-CRM-II-011
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500699779
—
OR
05
—
500730604
—
OR
Enumeration date
11/18/2013
Last updated
04/15/2025
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