Provider Demographics
NPI:1568023869
Name:VEGA-CAMARA, DANIELA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:ALEJANDRA
Last Name:VEGA-CAMARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 SW BARBUR BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5499
Mailing Address - Country:US
Mailing Address - Phone:503-222-9661
Mailing Address - Fax:
Practice Address - Street 1:9320 SW BARBUR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5499
Practice Address - Country:US
Practice Address - Phone:503-222-9661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health