Provider Demographics
NPI:1043464399
Name:BRADFUTE, MICHELE ANNE (CADC II)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNE
Last Name:BRADFUTE
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1869
Mailing Address - Country:US
Mailing Address - Phone:503-453-7879
Mailing Address - Fax:
Practice Address - Street 1:900 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1869
Practice Address - Country:US
Practice Address - Phone:503-453-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR08-08-30101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR08-08-30OtherTHE ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON