Basic Information
| Provider Information | |||||||||
| NPI: | 1932325214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARLOS | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | CADCII | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15178 SW WERT CT | ||||||||
| Address2: | |||||||||
| City: | SHERWOOD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971409823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036250581 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11945 SW PACIFIC HWY | ||||||||
| Address2: | #113 | ||||||||
| City: | TIGARD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972236469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036848159 | ||||||||
| FaxNumber: | 5035980934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 06-R-17 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.