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NPI Code Detail

MEDICARE: VICTORIA FELLINGHAM LCSW

MEDICARE:   VICTORIA  FELLINGHAM  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL4440OR

General Provider Information

NPI Number : 1639212632
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA FELLINGHAM LCSW
Provider Business Mailing Address
First Line : 9300 SE 91ST AVE STE 200
Second Line :
City : HAPPY VALLEY
State : OR
Zip : 97086-3762
Country : US
Telephone Number : 503-261-1171
Fax Number :
Provider Business Practice Location Address
First Line : 9300 SE 91ST AVE STE 200
Second Line :
City : HAPPY VALLEY
State : OR
Zip : 97086-3762
Country : US
Telephone Number : 503-261-1171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 06/01/2026

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Directions to “ VICTORIA FELLINGHAM LCSW” Practice Location

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