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General NPI Number Information
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NPI Number | 1386763142
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Entity Type | Individual
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Provider Name | IVETTE M IPARRAGUIRRE
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1312 SW WASHINGTON ST
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City | PORTLAND
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State | OR
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Zip | 97205-2327
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Country | US
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Telephone | 503-535-1151
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 SW 208TH AVE
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City | BEAVERTON
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State | OR
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Zip | 97006-1831
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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