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General NPI Number Information
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NPI Number | 1215139266
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Entity Type | Individual
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Provider Name | TREVOR MICHEAL PITTMAN
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3550 SE WOODWARD ST
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City | PORTLAND
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State | OR
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Zip | 97202-1552
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Country | US
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Telephone | 503-813-7765
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Fax |
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Provider Business Mailing Address
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Address Line | 2137 NW OAK GROVE DR
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City | ALBANY
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State | OR
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Zip | 97321-9357
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Country | US
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Telephone | 541-990-0187
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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