Individual
DEREK MIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
720 SE WASHINGTON ST, HILLSBORO, OR 97123-4230
(503) 648-0753
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
12/20/2021
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