Provider Demographics
NPI:1881029353
Name:MEULEMANS, DARLA A (MA CADC III)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:A
Last Name:MEULEMANS
Suffix:
Gender:F
Credentials:MA CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 NW 23RD AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2660
Mailing Address - Country:US
Mailing Address - Phone:503-757-9557
Mailing Address - Fax:503-653-9356
Practice Address - Street 1:1427 NW 23RD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2660
Practice Address - Country:US
Practice Address - Phone:503-757-9557
Practice Address - Fax:503-653-9356
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06-03-64101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)