Provider Demographics
NPI:1811640477
Name:BELSHER, DENISE A (CHW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:BELSHER
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 SW WICKIUP CT STE 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-8313
Mailing Address - Country:US
Mailing Address - Phone:541-604-0887
Mailing Address - Fax:
Practice Address - Street 1:3552 SW WICKIUP CT STE 200
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-8313
Practice Address - Country:US
Practice Address - Phone:541-604-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR105367172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORTHW000105367Medicaid