Provider Demographics
NPI:1578923082
Name:HARRIS, STEVEN LEE (CADC II, CDP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LEE
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CADC II, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10920 SW BARBUR BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8600
Mailing Address - Country:US
Mailing Address - Phone:503-244-4500
Mailing Address - Fax:503-244-2008
Practice Address - Street 1:10920 SW BARBUR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-8600
Practice Address - Country:US
Practice Address - Phone:503-244-4500
Practice Address - Fax:503-244-2008
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-12-11101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR17-02-12OtherACCBO
WA60772961OtherSTATE OF WASHINGTON