Provider Demographics
NPI:1922501402
Name:POSADAS, ARIELLE (LOTR, QMHP)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:POSADAS
Suffix:
Gender:F
Credentials:LOTR, QMHP
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:CRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOTR, QMHP
Mailing Address - Street 1:PO BOX 3973
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-3973
Mailing Address - Country:US
Mailing Address - Phone:503-730-2835
Mailing Address - Fax:971-204-7198
Practice Address - Street 1:3000 MARKET ST NE STE 507
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1807
Practice Address - Country:US
Practice Address - Phone:503-730-1469
Practice Address - Fax:971-204-7198
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR359025225X00000X
LA302499225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500742114Medicaid