Cardenas, Mario Alfonso

Cardenas, Mario Alfonso is an individual health care provider with primary practice located at 10570 Se Washington St , Portland OR 97216-2846. He recently has 2 registered licenses in different health care specialties including 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. Cardenas, Mario Alfonso can be contacted via phone (503) 995-3736.

Contact Information

Primary practice address
10570 Se Washington St Portland OR 97216-2846
Phone: (503) 995-3736
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X 12-CRM-074 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1427417500
LBN Legal business name Cardenas, Mario Alfonso
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2016
Last updated Jul 21st, 2022 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1427417500 NPPES
Oregon MEDICAID 12-CRM-074

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