Healthcare Provider Details
I. General information
NPI: 1669768701
Provider Name (Legal Business Name): ERIN BELLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2011
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 NW WALLULA AVE
GRESHAM OR
97030-5455
US
IV. Provider business mailing address
10313 SW 69TH AVE
TIGARD OR
97223-9103
US
V. Phone/Fax
- Phone: 503-726-3800
- Fax:
- Phone: 503-726-3800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: