Fothergill, Paula Lynn
Fothergill, Paula Lynn is an individual health care provider with primary practice located at 1776 Sw Madison St , Portland OR 97205-1715. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Fothergill, Paula Lynn can be contacted via phone (503) 224-1044.Contact Information
Primary practice address
1776 Sw Madison St
Portland OR 97205-1715
Phone: (503) 224-1044
Fax: (503) 621-2235
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 04-03-43U | Oregon |
Profile Details
| NPI number | 1700857497 |
|---|---|
| LBN Legal business name | Fothergill, Paula Lynn |
| Credentials | M.S., CADCII |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Jan 6th, 2016 - about 8 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 | 1700857497 | NPPES |
| Oregon | MEDICAID | 126370 |
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