Provider Demographics
NPI:1356489280
Name:PERALES, ELIDA PARRAS (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIDA
Middle Name:PARRAS
Last Name:PERALES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 EDGEWATER ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4049
Mailing Address - Country:US
Mailing Address - Phone:503-588-5816
Mailing Address - Fax:503-588-5803
Practice Address - Street 1:1245 EDGEWATER ST NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4049
Practice Address - Country:US
Practice Address - Phone:503-588-5816
Practice Address - Fax:503-588-5803
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical