Provider Demographics
NPI:1023322112
Name:MAINS, NORA
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:MAINS
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 1:11945 SW PACIFIC HIGHWAY
Mailing Address - Street 2:SUITE 113
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11945 SW PACIFIC HWY
Practice Address - Street 2:SUITE 113
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6469
Practice Address - Country:US
Practice Address - Phone:503-684-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)