Individual
ANGELIQUE S SAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM/PSS/QMHA-I
Contact information
Practice address
1310 SW 17TH AVE, PORTLAND, OR 97201-2522
(503) 231-2641
(503) 467-4077
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18-CRM-119
OR
101YM0800X
Mental Health Counselor
Primary
19-QMHA-I-00786
OR
175T00000X
Peer Specialist
THW000002507
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500729531
—
OR
05
—
500743399
—
OR
05
—
500761483
—
OR
Enumeration date
05/31/2017
Last updated
04/08/2022
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