Staten, Frederick Douglass

Staten, Frederick Douglass is an individual health care provider with primary practice located at 10920 Sw Barbur Blvd , Portland OR 97219-8600. 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. Staten, Frederick Douglass can be contacted via phone (503) 244-4500.

Contact Information

Primary practice address
10920 Sw Barbur Blvd Portland OR 97219-8600
Phone: (503) 244-4500
Fax: (503) 244-2008
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LH60296096 Washington
Behavioral Health & Social Service Providers / Professional 101YP2500X C4765 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1417216730
LBN Legal business name Staten, Frederick Douglass
Credentials PH.D.,LPC, CADC III
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2012
Last updated Mar 13th, 2026 - about 7 months 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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