Individual
MR. ELNATHAN HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II/QMHA-I
Contact information
Practice address
1438 SE DIVISION ST, PORTLAND, OR 97202-1140
(503) 548-0346
(503) 232-5959
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
04-P-06
OR
101YM0800X
Mental Health Counselor
Primary
19-QMHA-I-02175
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500686032
—
OR
05
—
500807103
—
OR
Enumeration date
02/25/2007
Last updated
06/29/2022
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