Provider Demographics
NPI:1457661860
Name:LUBARSKY-FORD, AARON M
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:LUBARSKY-FORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 NE 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2222
Mailing Address - Country:US
Mailing Address - Phone:503-228-9229
Mailing Address - Fax:503-228-9558
Practice Address - Street 1:727 NE 24TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2222
Practice Address - Country:US
Practice Address - Phone:503-228-9229
Practice Address - Fax:503-228-9558
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator