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NPI Code Detail

MEDICARE: NORA CHURCH MA

MEDICARE: NORA CHURCH MA
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
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health CounselorC3735OR

General Provider Information

NPI Number : 1528122553
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORA CHURCH MA
Provider Business Mailing Address
First Line : 500 NE MULTNOMAH ST FL 11
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2023
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3500 N INTERSTATE AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 09/09/2025

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Directions to “ NORA CHURCH MA” Practice Location

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