Douglass, Mark William
Douglass, Mark William is an sole proprietor health care provider with primary practice located at 10180 Se Sunnyside Rd , Clackamas OR 97015-8970. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Douglass, Mark William can be contacted via phone (503) 517-0878.Contact Information
Primary practice address
10180 Se Sunnyside Rd
Clackamas OR 97015-8970
Phone: (503) 517-0878
Fax: (503) 517-0866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | C2839 | Oregon |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 18-03-14 | Oregon |
Profile Details
| NPI number | 1023283660 |
|---|---|
| LBN Legal business name | Douglass, Mark William |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 24th, 2008 |
| Last updated | Nov 24th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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