Bird, Jill R
Bird, Jill R is an sole proprietor health care provider with primary practice located at 1605 E Lincoln Rd , Woodburn OR 97071-5137. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Bird, Jill R can be contacted via phone (503) 982-9300.Contact Information
Primary practice address
1605 E Lincoln Rd
Woodburn OR 97071-5137
Phone: (503) 982-9300
Fax: (503) 982-9308
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | THW3372 | Oregon |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 23-QMHA-R-3419 | Oregon |
Profile Details
| NPI number | 1043772411 |
|---|---|
| LBN Legal business name | Bird, Jill R |
| Credentials | QMHA, PSS, PWS, THW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 3rd, 2019 |
| Last updated | Mar 16th, 2023 - about 2 years ago |
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 | 1043772411 | NPPES |
| Oregon | Other | THW000003372 | OREGON HEALTH AUTHORITY |
| Oregon | Other | 23-QMHA-R-3419 | OREGON HEALTH AUTHORITY |
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