Provider Demographics
NPI:1891679841
Name:PERRINE, ANDREW RICHARD (CADC-R)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:RICHARD
Last Name:PERRINE
Suffix:
Gender:M
Credentials:CADC-R
Other - Prefix:
Other - First Name:ASH
Other - Middle Name:R
Other - Last Name:PERRINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC-R
Mailing Address - Street 1:1060 NE CLEVELAND AVE APT 238
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5739
Mailing Address - Country:US
Mailing Address - Phone:310-625-5801
Mailing Address - Fax:
Practice Address - Street 1:1535 N WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1885
Practice Address - Country:US
Practice Address - Phone:503-238-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-24-3851101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)