Individual
LINDA LOUISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
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
11-06-92
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500640327
—
OR
Enumeration date
11/02/2005
Last updated
06/11/2025
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