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General NPI Number Information
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NPI Number | 1679299291
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Entity Type | Individual
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Provider Name | AYUSHI CLARE PURELL
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 104 4TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321-2804
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Country | US
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Telephone | 808-640-9513
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 HILL ST SE
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City | ALBANY
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State | OR
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Zip | 97322-6711
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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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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