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General NPI Number Information
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NPI Number | 1306383989
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Entity Type | Organization
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Legal Business Name | BLACK PARENT INITIATIVE
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 2915 NE MARTIN LUTHER KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97212-3052
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Country | US
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Telephone | 503-284-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 NE MARTIN LUTHER KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97212-3052
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Country | US
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Telephone | 503-284-8000
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | KIMBERLY PORTER
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Credential | MSW
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Telephone | 971-400-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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