Individual
CARSON REID KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, CADC-R,
Contact information
Practice address
1500 NE IRVING ST STE 210, PORTLAND, OR 97232-2243
(855) 512-3909
Mailing address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-6106
(802) 598-6046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
R7969
OR
Other
Enumeration date
03/10/2022
Last updated
04/07/2025
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