Provider Demographics
NPI:1477833242
Name:CHADSEY, JEFF D
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:D
Last Name:CHADSEY
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 1:847 SW BROADWAY DR APT 34
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-3188
Mailing Address - Country:US
Mailing Address - Phone:503-701-0161
Mailing Address - Fax:
Practice Address - Street 1:494 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4141
Practice Address - Country:US
Practice Address - Phone:503-270-9809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health