George, Myron J
George, Myron J is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. George, Myron J 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | L1188 | Oregon |
Profile Details
| NPI number | 1497791123 |
|---|---|
| LBN Legal business name | George, Myron J |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Oct 1st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497791123 | NPPES |
| Oregon | MEDICAID | 500646551 |
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