Individual
MAKIAH CEARTAS WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
CADC-R/CSWA
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-24-4047
OR
104100000X
Social Worker
Primary
A14441
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500820479
—
OR
05
—
500846769
—
OR
Enumeration date
10/22/2018
Last updated
06/11/2025
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