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Provider Information for 1992126049


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SARENA MESTAS


Sex: Female

NPI: 1992126049
Last Updated: 2013-12-16
Certification Date:

Details

NameValue
NPI1992126049
Enumeration Date2013-12-16
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address PO BOX 8459
PORTLAND, OR 97207-8459
United States

Phone: 503-238-0769 | Fax:
 
Primary Practice Address 945 NE 165TH AVE
PORTLAND, OR 97230-6148
United States

Phone: 503-408-8100 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental Health