Individual
ETHEL MAE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(971) 217-9008
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-5778
OR
Other
Enumeration date
09/16/2025
Last updated
10/01/2025
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