Individual
BARBARA L IDROGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
17645 NW SAINT HELENS RD, PORTLAND, OR 97231-1729
(503) 621-1069
(503) 621-0200
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97206
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-05-45
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-16-447
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719002
—
OR
Enumeration date
12/27/2016
Last updated
02/02/2018
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