Irina Bautista
Counselor in Portland, OR. Individual provider (NPI-1).
NPI number1164073003
StatusActive
Last updated in NPPESSep 23, 2019
Details
- NPI
- 1164073003
- Entity type
- Individual (NPI-1)
- Name
- Irina Bautista
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2019
- Last updated
- Sep 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
3415 Se Powell BlvdPortland, OR 97202-3371
Phone 503-234-9591
Mailing address
3415 Se Powell BlvdPortland, OR 97202-3371
Phone 503-234-9591
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