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NPI Code Detail

MEDICARE: DINA SARAI RIVAS LCSW

MEDICARE: DINA SARAI RIVAS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL11041OR

General Provider Information

NPI Number : 1215470612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA SARAI RIVAS LCSW
Provider Business Mailing Address
First Line : 509 WARREN WAY
Second Line :
City : WOODBURN
State : OR
Zip : 97071-5862
Country : US
Telephone Number : 971-240-3004
Fax Number :
Provider Business Practice Location Address
First Line : 3400 STATE ST STE G750
Second Line :
City : SALEM
State : OR
Zip : 97301-7012
Country : US
Telephone Number : 541-900-4285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2016
Last Update Date : 09/10/2024

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Directions to “ DINA SARAI RIVAS LCSW” Practice Location

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