Individual
ADRIAN DIYA BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2318 NE MLK JR BLVD, PORTLAND, OR 97212-3715
(503) 335-8611
Mailing address
200 SE 7TH AVE, PORTLAND, OR 97214-1200
(503) 235-8655
(503) 802-0598
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-21-907
OR
175T00000X
Peer Specialist
22-CRM-II-0043
OR
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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