1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Peer Specialist
  6. NPI Profile

EDMOND ARLEN DOUGLAS
NPI 1790535599
Peer Specialist in Portland, OR

Active since March 25, 2024
3036 NE MLK JR BLVD, PORTLAND, OR 97212(503) 283-3763 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edmond Arlen Douglas NPPES

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

EDMOND ARLEN DOUGLAS (NPI 1790535599) is an individual peer specialist in Portland, Oregon and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1790535599
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameEDMOND ARLEN DOUGLAS
Location Address3036 NE MLK JR BLVDPortland, OR 97212-3053
Mailing AddressPo Box 8459Portland, OR 97207-8459
Phone(503) 283-3763
Sole ProprietorNo
Enumeration DateMarch 25, 2024
NPPES CertifiedMarch 25, 2024
✔ NPI 1790535599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
3036 NE MLK JR BLVD, Portland, OR 97212
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

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

ASHLEY BARDALES
Peer Specialist
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
JENIFER PREVOST
Peer Specialist
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
ANNDREA GLADYS VAUGHN
Case Manager/Care Coordinator
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 889-2500
JESSICA SHIRLEY CUSHMAN
Case Manager/Care Coordinator
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
MS. JUNIPER ELIZABETH WAGNER
Counselor (Mental Health)
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
BENJAMIN MICHAEL DAVIDSON
Student in an Organized Health Care Education/Training Program
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
MADELEINE ROSE POTTER PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
PHILIP JOHN MAGGI
Counselor (Addiction (Substance Use Disorder))
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763

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 Edmond Douglas's NPI number?

The NPI number for Edmond Douglas is 1790535599. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Where is Edmond Douglas located?

Edmond Douglas practices at 3036 NE Mlk Jr Blvd, Portland, OR 97212. The listed phone number is (503) 283-3763.

What is Edmond Douglas's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Edmond Douglas was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.