Provider Demographics
NPI:1902045370
Name:TONI BELLINGER PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TONI BELLINGER PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LMFT
Authorized Official - Phone:503-248-0030
Mailing Address - Street 1:14523 WESTLAKE DR STE 19
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-7700
Mailing Address - Country:US
Mailing Address - Phone:503-248-0030
Mailing Address - Fax:
Practice Address - Street 1:1942 NW KEARNEY ST
Practice Address - Street 2:#15
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1426
Practice Address - Country:US
Practice Address - Phone:503-248-0030
Practice Address - Fax:503-248-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health