Individual
TIM C GILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC 1
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1150
(503) 535-1192
Mailing address
2142 SE 52ND AVE, PORTLAND, OR 97215-3908
(503) 535-1150
(503) 535-1192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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