Provider Demographics
NPI:1780250043
Name:PINKSTON, ERIC JOSEPH (QMHP-C, CADC III)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JOSEPH
Last Name:PINKSTON
Suffix:
Gender:M
Credentials:QMHP-C, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15415 SE WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2742
Mailing Address - Country:US
Mailing Address - Phone:503-477-8495
Mailing Address - Fax:
Practice Address - Street 1:15415 SE WOODLAND WAY
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2742
Practice Address - Country:US
Practice Address - Phone:503-744-1854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21-03-20036101YA0400X
ORR9017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)