Provider Demographics
NPI:1124396122
Name:ORVIS, ASHLEY BRIANN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BRIANN
Last Name:ORVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 NE 109TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-5927
Mailing Address - Country:US
Mailing Address - Phone:775-223-4600
Mailing Address - Fax:
Practice Address - Street 1:13541 SE MARKET STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233
Practice Address - Country:US
Practice Address - Phone:503-258-9734
Practice Address - Fax:503-258-8892
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst