Individual
BRADLEY JOSEPH OSBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAS, CADCII, SUDP
Contact information
Practice address
4333 NE 113TH AVE, PORTLAND, OR 97220-2449
(970) 319-8001
Mailing address
4333 NE 113TH AVE, PORTLAND, OR 97220-2449
(970) 319-8001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-R-02
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
6654
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP61335275
WA
101YM0800X
Mental Health Counselor
22-QMHA-I-003318
OR
Other
Enumeration date
10/17/2012
Last updated
10/30/2024
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