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MIKE C THEODORE QMHA
NPI 1316644735
Counselor - Addiction (Substance Use Disorder) in Beaverton, OR

Active since February 15, 2023
17933 NW EVERGREEN PKWY STE 111, BEAVERTON, OR 97006(814) 243-0414(814) 479-5906 Get Directions Write a Review

NPPES record last updated: February 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mike C Theodore Qmha NPPES

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

MIKE C THEODORE QMHA (NPI 1316644735) is an individual addiction (substance use disorder) provider in Beaverton, Oregon, licensed in New York (35007) and active in the NPI registry since February 2023.

NPPES Registry Identity

NPI1316644735
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMIKE C THEODORECredential: QMHA
Location Address17933 NW EVERGREEN PKWY STE 111Beaverton, OR 97006-7452
Mailing Address3159 Carpenters Park RdDavidsville, PA 15928-9223 · (814) 243-0414 · Fax (814) 479-5906
Phone(814) 243-0414
Fax(814) 479-5906
Sole ProprietorNo
Enumeration DateFebruary 15, 2023
NPPES CertifiedFebruary 15, 2023
✔ NPI 1316644735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NY · 35007
17933 NW EVERGREEN PKWY STE 111, Beaverton, OR 97006
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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 Mike Theodore's NPI number?

The NPI number for Mike Theodore is 1316644735. It was assigned to this individual provider in the NPPES registry on February 15, 2023.

Where is Mike Theodore located?

Mike Theodore practices at 17933 NW Evergreen Pkwy Ste 111, Beaverton, OR 97006. The listed phone number is (814) 243-0414.

What is Mike Theodore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mike Theodore was last updated on February 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.