Individual
JOSHUA MCDANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
1122 NE 122ND AVE STE 200, PORTLAND, OR 97230-2081
(503) 594-4750
Mailing address
21724 SE ALDER DR APT 3, GRESHAM, OR 97030-2449
(503) 505-1577
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
T-23-3223
OR
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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