Provider Demographics
NPI:1568272391
Name:HAYES, CAMERON RICHARD TYLER (CADC-I, CRM-II)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:RICHARD TYLER
Last Name:HAYES
Suffix:
Gender:M
Credentials:CADC-I, CRM-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 NE GLISAN ST STE F
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3754
Mailing Address - Country:US
Mailing Address - Phone:808-773-2991
Mailing Address - Fax:
Practice Address - Street 1:5932 NE GLISAN ST STE F
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3754
Practice Address - Country:US
Practice Address - Phone:808-773-2991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22-CRM-II-0067175T00000X
OR24-10-11258101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist