Provider Demographics
NPI:1962269720
Name:DURAN RAMIREZ, CARMEN ROCIO (CADCR,CRM, CGRM, PWS)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:ROCIO
Last Name:DURAN RAMIREZ
Suffix:
Gender:F
Credentials:CADCR,CRM, CGRM, PWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16040
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292
Mailing Address - Country:US
Mailing Address - Phone:503-535-1150
Mailing Address - Fax:503-535-1192
Practice Address - Street 1:205 SE 3RD AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123
Practice Address - Country:US
Practice Address - Phone:503-535-1150
Practice Address - Fax:503-693-6474
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)