Individual
DERRICK RADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106
(971) 290-4398
Mailing address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106
(971) 290-4398
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
61660503
WA
101YM0800X
Mental Health Counselor
Primary
R9219
OR
Other
Enumeration date
05/15/2023
Last updated
04/08/2025
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