Provider Demographics
NPI:1598802001
Name:GREENE, ERIN MICHELE
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:MICHELE
Last Name:GREENE
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 1:510 SE 53RD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1800
Mailing Address - Country:US
Mailing Address - Phone:503-236-6387
Mailing Address - Fax:
Practice Address - Street 1:945 NE 165TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6148
Practice Address - Country:US
Practice Address - Phone:503-408-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered372600000XNursing Service Related ProvidersAdult Companion