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NPI Code Detail

MEDICARE: MICHELLE E LONG

MEDICARE: MICHELLE E LONG
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
1101Y00000XCounselorRC00054698WA
2101YM0800XMental Health CounselorLH60180617WA
3101YP2500XProfessional CounselorC2650OR

General Provider Information

NPI Number : 1972663615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE E LONG
Provider Business Mailing Address
First Line : 3175 NE ALOCLEK DR
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-7135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3175 NE ALOCLEK DR
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-7135
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 12/21/2021

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Directions to “ MICHELLE E LONG ” Practice Location

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