Vazquez, Carlos Jorge
Vazquez, Carlos Jorge is an individual health care provider with primary practice located at 3800 Sw Cedar Hills Blvd Ste 170 , Beaverton OR 97005-2020. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Vazquez, Carlos Jorge can be contacted via phone (503) 626-1800.Contact Information
Primary practice address
3800 Sw Cedar Hills Blvd Ste 170
Beaverton OR 97005-2020
Phone: (503) 626-1800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | G-24-05-1018 | Oregon |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 25-QMHA-II-000461 | Oregon |
| Other Service Providers / Peer Specialist | 175T00000X | 21-CRM-704 | Oregon |
| Other Service Providers / Peer Specialist | 175T00000X | 23-CGRM-020 | Oregon |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 23-06-20284 | Oregon |
Profile Details
| NPI number | 1053850750 |
|---|---|
| LBN Legal business name | Vazquez, Carlos Jorge |
| Credentials | CADC,CGAC,QMHA,CRM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2017 |
| Last updated | Jan 7th, 2026 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053850750 | NPPES |
| Oregon | Other | G-24-05-1018 | MHACBO CGAC-I |
| Oregon | Other | 23-06-20284 | MHACBO CGAC-I |
| Oregon | MEDICAID | 500732064 | MHACBO CGAC-I |
| Oregon | Other | 23-CGRM-020 | MHACBO CGAC-I |
| Oregon | Other | 21-CRM-704 | MHACBO CGAC-I |
| Oregon | Other | 25-QMHA-II-000461 | MHACBO CGAC-I |
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