Individual
JOEMAL D BONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC CANDIDATE/QMHA
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-16-238
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
101YM0800X
Mental Health Counselor
—
OR
Other
Enumeration date
07/06/2016
Last updated
03/17/2018
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