Provider Demographics
NPI:1932325214
Name:BARLOS, DEBRA K (CADCII)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:BARLOS
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15178 SW WERT CT
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9823
Mailing Address - Country:US
Mailing Address - Phone:503-625-0581
Mailing Address - Fax:
Practice Address - Street 1:11945 SW PACIFIC HWY
Practice Address - Street 2:#113
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6469
Practice Address - Country:US
Practice Address - Phone:503-684-8159
Practice Address - Fax:503-598-0934
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06-R-17101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)