Individual
CAROLINE BRISBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I/CRM II
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-06-11143
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
24-CRM-II-0229
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500812211
—
OR
05
—
500812212
—
OR
Enumeration date
10/25/2022
Last updated
06/27/2024
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