Dismuke, Chanel Breae
Dismuke, Chanel Breae is an individual health care provider with primary practice located at 1975 Nw 167Th Pl Ste 100-42 , Beaverton OR 97006-4908. She recently has 3 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 / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Dismuke, Chanel Breae can be contacted via phone (503) 436-5663.Contact Information
Primary practice address
1975 Nw 167Th Pl Ste 100-42
Beaverton OR 97006-4908
Phone: (503) 436-5663
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 3292 | Oregon |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 3292 | Oregon |
Profile Details
| NPI number | 1780053314 |
|---|---|
| LBN Legal business name | Dismuke, Chanel Breae |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 24th, 2015 |
| Last updated | Jul 4th, 2024 - 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.
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