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Individual

PRENTICE GEARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC III, QMHA

Contact information

Practice address
880 82ND DR, GLADSTONE, OR 97027-1803
(971) 378-0367
(503) 974-9679
Mailing address
880 82ND DR, GLADSTONE, OR 97027-1803
(971) 378-0367
(503) 974-9679

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18-01-43
OR
171M00000X
Case Manager/Care Coordinator
Primary
21-QMHA-II-000009
OR

Other

Enumeration date
11/13/2018
Last updated
02/13/2026
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