Provider Demographics
NPI:1124917349
Name:CHRIS HUMPHREYS LLC
Entity type:Organization
Organization Name:CHRIS HUMPHREYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:HUMPHREYS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-708-2891
Mailing Address - Street 1:850 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-6389
Mailing Address - Country:US
Mailing Address - Phone:503-708-2891
Mailing Address - Fax:541-429-4118
Practice Address - Street 1:1100 SOUTHGATE STE 3
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3971
Practice Address - Country:US
Practice Address - Phone:541-215-4440
Practice Address - Fax:541-429-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500771872Medicaid