Individual
CORY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHP-R
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
(971) 217-9008
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
26-QMHP-R-4098
OR
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
02/23/2026
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