Individual
KALVIN VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
6601 NE 78TH CT STE A3, PORTLAND, OR 97218-2823
(971) 361-0798
Mailing address
6601 NE 78TH CT STE A3, PORTLAND, OR 97218-2823
(971) 361-0798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1691
OR
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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