Provider Demographics
NPI:1033401419
Name:R L PEREZ, PC
Entity Type:Organization
Organization Name:R L PEREZ, PC
Other - Org Name:NEW FOUNDATION INNER HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:503-266-1407
Mailing Address - Street 1:550 NW 3RD AVE
Mailing Address - Street 2:STE E
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3546
Mailing Address - Country:US
Mailing Address - Phone:503-266-1407
Mailing Address - Fax:503-266-1849
Practice Address - Street 1:550 NW 3RD AVE
Practice Address - Street 2:STE E
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3546
Practice Address - Country:US
Practice Address - Phone:503-266-1407
Practice Address - Fax:503-266-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR01184171-4251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health