Healthcare Provider Details

I. General information

NPI: 1285440867
Provider Name (Legal Business Name): AUBRIEL ROSE FEINSTEIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUBRIEL ROSE JOHNSON

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 NE HOOD AVE
GRESHAM OR
97030-7328
US

IV. Provider business mailing address

4423 SE 45TH AVE
PORTLAND OR
97206-4011
US

V. Phone/Fax

Practice location:
  • Phone: 971-404-4668
  • Fax:
Mailing address:
  • Phone: 971-420-6209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberR10345
License Number StateOR

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: