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Individual

BRADLEY CHARLES VILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRM/ CADC1-R/ QMHA-R

Contact information

Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
(503) 432-9259

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
Primary
18-CRM-366
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18-CRM-366
CRM CERTIFICATION
OR
Enumeration date
06/17/2019
Last updated
10/13/2022
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