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Individual

MR. WYNDHAM PIERCE MCNAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CADC I

Contact information

Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1150
(503) 535-1191
Mailing address
P O BOX 3007, PORTLAND, OR 97208
(503) 535-1150
(503) 535-1191

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-06--50
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11-06-50
ACCBO CADC I A&D CERTIFICATION
OR
Enumeration date
07/17/2012
Last updated
07/17/2012
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