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PEGGY LACOMBE CADCII

Addiction Substance Use Disorder

Portland, Oregon

Provider NPI: 1124019617

Provider Information:
 PEGGY  LACOMBE CADCII
Gender: F


Practice Location:
1631 SW COLUMBIA ST  PORTLAND, OR 97201 US
Tel: 503-231-2641  Fax: 503-231-1654

Business Mailing Address:
1776 SW MADISON ST  PORTLAND, OR 97205 US
Tel: 503-231-2641  Fax: 503-231-1654

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
OR951030

Other Provider Identifiers:

IssuerNumberStateType
126370OR05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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