Individual
BRYAN RICHARD DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
411 NE 19TH AVE, PORTLAND, OR 97232-4801
(971) 386-2126
Mailing address
411 NE 19TH AVE, PORTLAND, OR 97232-4801
(971) 386-2126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-3679
OR
Other
Enumeration date
02/13/2024
Last updated
02/10/2025
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