Healthcare Provider Details

I. General information

NPI: 1851205181
Provider Name (Legal Business Name): MARIA LUA NAVA CHW/THW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9487 PORTER RD SE
AUMSVILLE OR
97325-9767
US

IV. Provider business mailing address

9487 PORTER RD SE
AUMSVILLE OR
97325-9767
US

V. Phone/Fax

Practice location:
  • Phone: 503-800-1255
  • Fax:
Mailing address:
  • Phone: 503-800-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number117940
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: