Individual
MR. WILLIAM JAMES BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC INTERN
Contact information
Practice address
2415 SE 43RD AVE, SUITE 200, PORTLAND, OR 97206-1600
(503) 872-0187
Mailing address
768 SE 193RD AVE, APT. C-316, PORTLAND, OR 97233-5784
(503) 674-4941
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PRE-CADC INTERN
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2007
Last updated
11/08/2007
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