Churchill, Virginia A

Churchill, Virginia A is an individual health care provider with primary practice located at 2415 Se 43Rd Ave Suite 100, Portland OR 97206-1600. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Churchill, Virginia A can be contacted via phone (503) 797-6689.

Contact Information

Primary practice address
2415 Se 43Rd Ave Suite 100 Portland OR 97206-1600
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1962458448
LBN Legal business name Churchill, Virginia A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Jul 8th, 2007 - about 17 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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