Campbell, Sadie A

Campbell, Sadie A is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Campbell, Sadie A can be contacted via phone (971) 274-3757.

Contact Information

Primary practice address
620 Ne 2Nd St Gresham OR 97030
Phone: (971) 274-3757
Fax: (503) 912-5740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 19-QMHA-I-00637 Oregon
Other Service Providers / Peer Specialist 175T00000X THW000001573 Oregon

Profile Details

NPI number 1538517420
LBN Legal business name Campbell, Sadie A
Credentials PSS/QMHA-I
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2016
Last updated Aug 16th, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538517420 NPPES
Oregon MEDICAID 500747179
Oregon MEDICAID 500733945

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