Individual
DANIEL WAYNE BERRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3610 NE 82ND AVE, PORTLAND, OR 97220-5182
(503) 408-9585
(503) 208-2596
Mailing address
3610 NE 82ND AVE, PORTLAND, OR 97220-5182
(503) 408-9585
(503) 408-9456
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-12-13
CADC I
OR
Enumeration date
02/14/2018
Last updated
05/29/2019
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