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Individual

CORT MICAH DORN-MEDEIROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CADC I

Contact information

Practice address
2020 SE 182ND AVE, PORTLAND, OR 97233-5692
(503) 988-5400
(503) 988-5668
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 988-5400
(503) 988-5668

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
C3390
OR

Other

Enumeration date
01/12/2011
Last updated
01/21/2015
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