Green, Genetthia Tashawna

Green, Genetthia Tashawna is an individual health care provider with primary practice located at 847 Ne 19Th Ave Suite 100, Portland OR 97232-2684. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Green, Genetthia Tashawna can be contacted via phone (503) 238-0769.

Contact Information

Primary practice address
847 Ne 19Th Ave Suite 100 Portland OR 97232-2684
Phone: (503) 238-0769
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1205261294
LBN Legal business name Green, Genetthia Tashawna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2013
Last updated Sep 30th, 2015 - about 10 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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