Provider Demographics
NPI:1437831526
Name:ADER, DEREK (CADC-R)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:ADER
Suffix:
Gender:M
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18600 SE MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6723
Mailing Address - Country:US
Mailing Address - Phone:971-255-0658
Mailing Address - Fax:971-236-8080
Practice Address - Street 1:31700 FAYETTEVILLE DR
Practice Address - Street 2:
Practice Address - City:SHEDD
Practice Address - State:OR
Practice Address - Zip Code:97377-9779
Practice Address - Country:US
Practice Address - Phone:503-208-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)