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General NPI Number Information
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NPI Number | 1265887525
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE AVILA LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 11630 SE 40TH AVE
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City | MILWAUKIE
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State | OR
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Zip | 97222-6195
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Country | US
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Telephone | 503-877-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 NE 136TH AVE # A9
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City | VANCOUVER
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State | WA
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Zip | 98684-5972
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Country | US
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Telephone | 619-733-5608
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L30036
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License Number State | OR
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