Bristow, Amy L
Bristow, Amy L is an individual health care provider with primary practice located at 125 Sw C St , Madras OR 97741-1458. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Bristow, Amy L can be contacted via phone (541) 306-4566.Contact Information
Primary practice address
125 Sw C St
Madras OR 97741-1458
Phone: (541) 306-4566
Fax: (541) 320-9005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | 19-CRM-100 | Oregon |
Profile Details
| NPI number | 1659937852 |
|---|---|
| LBN Legal business name | Bristow, Amy L |
| Credentials | CRM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2019 |
| Last updated | May 13th, 2019 - about 5 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 | 1659937852 | NPPES |
| Oregon | Other | 19-CRM-100 | CERTIFIED RECOVERY MENTOR |
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