Individual
SHAKOTA WEIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC R
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 242-8544
Mailing address
2934 SE BAKER AVE, GRESHAM, OR 97080-8665
(503) 991-0965
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
11/28/2025
Last updated
11/28/2025
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