Individual
DANA WECKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I, QMHA
Contact information
Practice address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-12-46
OR
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500700195
—
OR
Enumeration date
05/10/2014
Last updated
03/07/2017
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