Provider Demographics
NPI:1033754197
Name:PRESTON, CHELSEA AMBER (MA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:AMBER
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 SW MAGNOLIA PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6271
Mailing Address - Country:US
Mailing Address - Phone:949-371-7398
Mailing Address - Fax:
Practice Address - Street 1:7950 SW MAGNOLIA PL
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6271
Practice Address - Country:US
Practice Address - Phone:949-371-7398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist