Provider Demographics
NPI:1871231886
Name:GREENE, CHELSIE P
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:P
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 1:3737 PORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0311
Mailing Address - Country:US
Mailing Address - Phone:503-390-2600
Mailing Address - Fax:
Practice Address - Street 1:3745 PORTLAND RD NE STE 120
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0529
Practice Address - Country:US
Practice Address - Phone:503-390-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health