Provider Demographics
NPI:1619761863
Name:IBEKWE, CHINYERE CHRISTY
Entity type:Individual
Prefix:
First Name:CHINYERE
Middle Name:CHRISTY
Last Name:IBEKWE
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 1:186 NE 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6879
Mailing Address - Country:US
Mailing Address - Phone:424-386-2525
Mailing Address - Fax:
Practice Address - Street 1:16535 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-5143
Practice Address - Country:US
Practice Address - Phone:503-259-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health