White Elk, Andulia
White Elk, Andulia is an individual health care provider with primary practice located at 1631 Sw Columbia St , Portland OR 97201-6025. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. White Elk, Andulia can be contacted via phone (503) 231-2641.Contact Information
Primary practice address
1631 Sw Columbia St
Portland OR 97201-6025
Phone: (503) 231-2641
Fax: (503) 231-1654
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 050757 | Oregon |
Profile Details
| NPI number | 1053302554 |
|---|---|
| LBN Legal business name | White Elk, Andulia |
| Credentials | CADCI |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1053302554 | NPPES |
| Oregon | MEDICAID | 126370 |
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