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Provider Information for 1386818656


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RAMATA KAZADI ADEBAWO QMHP


Sex: Female

NPI: 1386818656
Last Updated: 2022-04-30
Certification Date: 2022-04-30

Details

NameValue
NPI1386818656
Enumeration Date2008-04-17
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 8383 NE SANDY BLVD
430 SUITE
PORTLAND, OR 97220-2243
United States

Phone: 503-593-0134 | Fax:
 
Primary Practice Address 8383 NE SANDY BLVD STE 430
PORTLAND, OR 97220-4998
United States

Phone: 503-593-0134 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental Health
Yes 1041C0700X - Social Worker - ClinicalORL10747