Casillas, Vanessa Abigail

Casillas, Vanessa Abigail is an individual health care provider with primary practice located at 4920 N Interstate Ave , Portland OR 97217-3653. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Casillas, Vanessa Abigail can be contacted via phone (503) 215-3300.

Contact Information

Primary practice address
4920 N Interstate Ave Portland OR 97217-3653
Phone: (503) 215-3300
Fax: (503) 215-3350
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 2090 Oregon
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2090 Oregon

Profile Details

NPI number 1235432287
LBN Legal business name Casillas, Vanessa Abigail
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2010
Last updated Oct 14th, 2020 - about 4 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 1235432287 NPPES
Oregon MEDICAID 500631879

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