PAUL DOUG DERHAM CADC-R NPI 1003795618

NPI Information

  • NPI: 1003795618
  • Provider Name: PAUL DOUG DERHAM, CADC-R
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 4713 N ALBINA AVE STE 301
    PORTLAND, OR
    ZIP 97217
  • Phone: (503) 707-9771

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NPI Details

Paul Doug Derham, CADC-R is an addiction (substance use disorder) counselor in Portland, OR. Paul Doug Derham, CADC-R NPI is 1003795618. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4713 N ALBINA AVE STE 301
PORTLAND, OR
ZIP 97217-605
Phone: (503) 707-9771

The enumeration date for this NPI number is 8/28/2025 and was last updated on 8/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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