Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Anthony Douglas Dejesus, SUDPT, CADC-R

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1871140350

Mr. Anthony Douglas Dejesus, SUDPT, CADC-R is an Addiction (Substance Use Disorder) Counselor in Portland, Oregon. Licensed in Washington. Registered with an NPI since 2019.

Licensed in
WA
In the registry since
2019

Practice location Address checks out

12662 SE Stark St
Portland, OR 97233-1058
Phone: (503) 546-7677
Fax: (503) 517-7768
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CO60778717 (WA)

Record details

NPI number1871140350
Entity typeIndividual (Type 1)
GenderMale
Credentials SUDPT , CADC-R
Sole proprietorNo
NPI enumeratedAugust 20, 2019
Last updated in NPPESFebruary 16, 2021
Certification dateFebruary 16, 2021

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