Perry, Mary L

Perry, Mary L is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030-7514. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Perry, Mary L can be contacted via phone (971) 274-3757.

Contact Information

Primary practice address
620 Ne 2Nd St Gresham OR 97030-7514
Phone: (971) 274-3757
Fax: (503) 912-5740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X THW000104717 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 21-CRM-611 Oregon

Profile Details

NPI number 1093380305
LBN Legal business name Perry, Mary L
Credentials CRM/PSS
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2021
Last updated Jan 4th, 2023 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1093380305 NPPES
Oregon MEDICAID 500793670

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