Provider Demographics
NPI:1689872780
Name:FORD, MONICA JOYCE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:JOYCE
Last Name:FORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:JOYCE
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11456 NE KNOTT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-1706
Mailing Address - Country:US
Mailing Address - Phone:503-736-6500
Mailing Address - Fax:503-256-9601
Practice Address - Street 1:1500 NE IRVING ST
Practice Address - Street 2:250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2243
Practice Address - Country:US
Practice Address - Phone:503-233-4356
Practice Address - Fax:503-233-4359
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker