Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE ANTHONY GONZALES, C.R.M.
Active Sole ProprietorSHANE ANTHONY GONZALES, C.R.M. is a Substance Use Disorder Rehabilitation Facility healthcare provider located in PORTLAND, Oregon. NPI 1245065366 is currently active in the NPPES registry. Verify at CMS.
Substance Use Disorder Rehabilitation Facility · PORTLAND, OR
Registration Details
- NPI Number
- 1245065366
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 6, 2024 (1.8927731381315 yrs)
- Last Updated
- Sep 6, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
1122 NE 122ND AVE STE A200PORTLAND, OR, 972302083Browse OR providers · Browse ZIP 97230
- Phone
- 5035944774
- Primary Specialty
-
Substance Use Disorder Rehabilitation Facility
261QR0405X
Other Substance Use Disorder Rehabilitation Facility Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| MRS. EMILY ELIZABETH LUND | LPN | 1720441470 |
| JOSHUA MCDANNELL | CADC-R | 1386417335 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.