Individual
DIANA M. DEBRUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7412 SW BEAVERTON HILLSDALE HWY STE 204, PORTLAND, OR 97225-2168
(503) 719-2799
(888) 972-3736
Mailing address
7412 SW BEAVERTON HILLSDALE HWY STE 204, PORTLAND, OR 97225-2168
(503) 719-2799
(888) 972-3736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
501728
OR
101YP2500X
Professional Counselor
Primary
C0983
OR
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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