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
Fax: (503) 231-1654
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053302554 NPPES
Oregon MEDICAID 126370

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