Individual
PAUL MODESITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC1
Contact information
Practice address
900 MAIN ST STE 200, OREGON CITY, OR 97045-1869
(971) 386-3401
(503) 723-6653
Mailing address
706 MAIN ST, OREGON CITY, OR 97045-1815
(503) 655-1029
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
175T00000X
Peer Specialist
17-CRM-187
OR
Other
Enumeration date
02/26/2018
Last updated
01/06/2022
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