Provider Demographics
NPI:1336294768
Name:CHRISTOPHER, COLIN WARREN (QMHP)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:WARREN
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 SE ANKENY ST
Mailing Address - Street 2:APT 207
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1764
Mailing Address - Country:US
Mailing Address - Phone:503-913-3343
Mailing Address - Fax:
Practice Address - Street 1:2623 SE ANKENY ST
Practice Address - Street 2:APT 207
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1764
Practice Address - Country:US
Practice Address - Phone:503-913-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)