Individual
CODY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 MAIN ST STE 200, OREGON CITY, OR 97045-1869
(503) 465-2749
Mailing address
PO BOX 16576, PORTLAND, OR 97292-0576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-21-733
OR
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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