Provider Demographics
NPI:1003630294
Name:EHLENBACH, FERRAH (MA, LMFTA)
Entity type:Individual
Prefix:
First Name:FERRAH
Middle Name:
Last Name:EHLENBACH
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35384 FIRLOCK PARK
Mailing Address - Street 2:
Mailing Address - City:ST HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051
Mailing Address - Country:US
Mailing Address - Phone:509-630-0255
Mailing Address - Fax:
Practice Address - Street 1:1110 SE ALDER ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:458-204-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health