Individual
ROGER KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Mailing address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
01-R-17
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01-R-17
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-R-17
MHACBO CADC-II
OR
05
—
500786243
—
OR
Enumeration date
04/14/2014
Last updated
03/29/2021
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