Individual
MR. DAVID WARREN COOPER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC III
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 235-8655
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 802-0598
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-05-15
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC III 161070
OH
Other
Enumeration date
02/19/2015
Last updated
11/16/2021
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