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Individual

BRANDON PAUL WOMACK-MEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S., CADC I, QHMA

Contact information

Practice address
709 NW EVERETT ST, PORTLAND, OR 97209-3517
(503) 226-4060
Mailing address
709 NW EVERETT ST, PORTLAND, OR 97209-3517
(503) 226-4060

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-12-69
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12-12-69
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON
OR
Enumeration date
02/17/2007
Last updated
02/25/2013
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