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General NPI Number Information
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NPI Number | 1851835722
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Entity Type | Organization
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Legal Business Name | CHANGEPOINT, INC
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 1700 NW 167TH PLACE SUITE 240
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City | BEAVERTON
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State | OR
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Zip | 97006
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Country | US
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Telephone | 503-350-2758
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Fax | 503-350-1790
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Provider Business Mailing Address
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Address Line | 1700 NW PLACE SUITE 240
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City | BEAVERTON
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State | OR
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Zip | 97006
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Country | US
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Telephone | 503-350-2758
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Fax | 503-350-1790
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Authorized Official
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Title or Position | SUBSTANCE USE DISORDER COUNSELOR
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Name | JUAN HERNANDEZ PEREZ
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Credential | CADCI
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Telephone | 503-352-8261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 15-03-12
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License Number State | OR
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