Abbott, Miya Gray
Abbott, Miya Gray is an sole proprietor health care provider with primary practice located at 2304 E. Bumside St. Suite 201, Portland OR 97214. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Abbott, Miya Gray can be contacted via phone (503) 951-0328.Contact Information
Primary practice address
2304 E. Bumside St. Suite 201
Portland OR 97214
Phone: (503) 951-0328
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | L4914 | Oregon |
Profile Details
NPI number | 1053595785 |
---|---|
LBN Legal business name | Abbott, Miya Gray |
Credentials | LICENSED CLINICAL SO |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 17th, 2007 |
Last updated | Oct 23rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053595785 | NPPES |
Oregon | MEDICAID | 500637536 |
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