Provider Demographics
NPI:1386818656
Name:ADEBAWO, RAMATA KAZADI (QMHP)
Entity Type:Individual
Prefix:
First Name:RAMATA
Middle Name:KAZADI
Last Name:ADEBAWO
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 NE SANDY BLVD
Mailing Address - Street 2:430 SUITE
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-2243
Mailing Address - Country:US
Mailing Address - Phone:503-593-0134
Mailing Address - Fax:
Practice Address - Street 1:8383 NE SANDY BLVD STE 430
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4998
Practice Address - Country:US
Practice Address - Phone:503-593-0134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORL107471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health