Individual
MRS. ANDREA S. BRADWAY-KUSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC 1, QHMP, THW
Contact information
Practice address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/13/2016
Last updated
09/12/2017
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