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SHANE ANTHONY GONZALES C.R.M.
NPI 1245065366
Clinic/Center - Rehabilitation, Substance Use Disorder in Portland, OR

Active since September 06, 2024
1122 NE 122ND AVE STE A200, PORTLAND, OR 97230(503) 594-4774 Get Directions Write a Review

NPPES record last updated: September 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shane Anthony Gonzales C.r.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE ANTHONY GONZALES C.R.M. (NPI 1245065366) is an individual rehabilitation, substance use disorder provider in Portland, Oregon and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1245065366
Entity TypeIndividualMale
Primary Taxonomy261QR0405X
Provider Legal NameSHANE ANTHONY GONZALESCredential: C.R.M.
Location Address1122 NE 122ND AVE STE A200Portland, OR 97230-2083
Mailing Address1122 Ne 122nd Ave Ste A200Portland, OR 97230-2083 · (503) 594-4774
Phone(503) 594-4774
Sole ProprietorYes
Enumeration DateSeptember 6, 2024
NPPES CertifiedSeptember 6, 2024
✔ NPI 1245065366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
1122 NE 122ND AVE STE A200, Portland, OR 97230
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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL A REISER
Student in an Organized Health Care Education/Training Program
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4750
ZACHARY PALMER ALEXANDER
Social Worker
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4750
GINGER LORIE JONES CADC-R
Counselor (Addiction (Substance Use Disorder))
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4750
LISA LYNN VESELY
Counselor (Addiction (Substance Use Disorder))
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4750
JUSTINA RAMERIZ CADC-R
Counselor (Addiction (Substance Use Disorder))
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4766
MICHAEL HORSBURGH PSS, THW
Peer Specialist
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (971) 997-2781
BRIAN JAMES CRABTREE CRM, CADC-R
Peer Specialist
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 594-4766
DEBORAH L HARDING-ELLIOTT CACD-R
Counselor (Addiction (Substance Use Disorder))
1122 NE 122ND AVE STE A200
PORTLAND, OR 97230
Multnomah County (503) 954-1890

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Gonzales's NPI number?

The NPI number for Shane Gonzales is 1245065366. It was assigned to this individual provider in the NPPES registry on September 6, 2024.

Where is Shane Gonzales located?

Shane Gonzales practices at 1122 NE 122nd Ave Ste A200, Portland, OR 97230. The listed phone number is (503) 594-4774.

What is Shane Gonzales's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Shane Gonzales was last updated on September 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.