Provider Demographics
NPI:1841684552
Name:AVIV, HAVA N (MA)
Entity type:Individual
Prefix:
First Name:HAVA
Middle Name:N
Last Name:AVIV
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 NW ALEXANDRA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-1289
Mailing Address - Country:US
Mailing Address - Phone:503-731-3960
Mailing Address - Fax:503-239-1252
Practice Address - Street 1:2640 NW ALEXANDRA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-1289
Practice Address - Country:US
Practice Address - Phone:503-731-3960
Practice Address - Fax:503-239-1252
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator