Individual
PAUL O NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC CANDIDATE/QMHP
Contact information
Practice address
17645 NW SAINT HELENS RD, PORTLAND, OR 97231
(503) 621-1069
(503) 621-0200
Mailing address
19474 SE 38TH WAY, CAMAS, WA 97607
(650) 430-7285
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-18-281
OR
101YM0800X
Mental Health Counselor
—
OR
106H00000X
Marriage & Family Therapist
56125
CA
106H00000X
Marriage & Family Therapist
IMF80598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500746319
—
OR
05
—
500747233
—
OR
Enumeration date
10/13/2015
Last updated
02/13/2019
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