Individual
BUSTER ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CADC II, LPC-I
Contact information
Practice address
1901 ESTHER ST, NEWBERG, OR 97132-9529
(505) 490-9481
Mailing address
5932 SE MILWAUKIE AVE, PORTLAND, OR 97202-5258
(505) 490-9481
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-R-05
OR
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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