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Individual

SANDRA CAVAZOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRM/QMHA-R

Contact information

Practice address
1310 SW 17TH AVE, PORTLAND, OR 97201-2522
(971) 261-0544
(971) 245-3043
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-CRM-3435
OR
101YM0800X
Mental Health Counselor
25-QMHA-R-7304
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500858251
OR
Enumeration date
03/12/2020
Last updated
07/31/2025
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