Provider Demographics
NPI:1063841674
Name:MENTAL HEALTH ASSOCIATION OF OREGON
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF OREGON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZULICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:5039-222-2377
Mailing Address - Street 1:10150 SE ANKENY ST STE 201A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2369
Mailing Address - Country:US
Mailing Address - Phone:503-922-2377
Mailing Address - Fax:503-922-2360
Practice Address - Street 1:10150 SE ANKENY ST STE 201A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2369
Practice Address - Country:US
Practice Address - Phone:503-922-2377
Practice Address - Fax:503-922-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health