Provider Demographics
NPI:1205147162
Name:ROCHON, EMILY E (CADC I)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:ROCHON
Suffix:
Gender:F
Credentials:CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W BURNSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3817
Mailing Address - Country:US
Mailing Address - Phone:503-544-9666
Mailing Address - Fax:503-467-4707
Practice Address - Street 1:421 W BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3817
Practice Address - Country:US
Practice Address - Phone:503-544-9666
Practice Address - Fax:503-467-4707
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR03-03-34101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR03-03-34OtherADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON