Theodore Lee Pearson Iii, CADC I is a
Student In An Organized Health Care Education/training Program based in Portland, Oregon. Theodore Lee Pearson Iii is licensed to practice in * (Not Available) (license number ) and his current practice location is
1122 Ne 122nd Ave # 200, Portland, Oregon. He can be reached at his office (for appointments etc.) via phone at
(503) 732-6653.
NPI number for Theodore Lee Pearson Iii is 1508591637 and his current mailing address is Po Box 1038, West Tisbury, Massachusetts. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508591637.
Healthcare Provider's Profile
| Full Name | Theodore Lee Pearson Iii |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1122 Ne 122nd Ave # 200, Portland, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1508591637
- Provider Enumeration Date: 07/21/2022
- Last Update Date: 09/26/2023
Medical Identifiers
Medical identifiers for Theodore Lee Pearson Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508591637 | NPI | - | NPPES |
| 20-05-10416 | Other | OR | MHACBO |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 20-05-10416 (Oregon) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodore Lee Pearson Iii is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Theodore Lee Pearson Iii, CADC I
Po Box 1038,
West Tisbury, MA 02575-1038
Ph: (503) 475-6246 | Theodore Lee Pearson Iii, CADC I
1122 Ne 122nd Ave # 200,
Portland, OR 97230-2081
Ph: (503) 732-6653 |
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