Charlie Irene Andrade
Individual provider Active NPI Behavior Technician · Gresham, OR
NPI 1275209181 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1275209181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 912 NE Kelly Ave # 100C
Gresham, OR 97030-5629 - Phone
- (503) 912-5502
- NPI assigned
- Aug 19, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | OR | Yes |
Addresses
Primary practice location
912 NE Kelly Ave # 100C
Gresham, OR 97030-5629
Mailing address
21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345
Other providers in Gresham, OR
- Krystle Anderson
- Lori Ann Anderson
- Terri Lynn Anderson
- Thomas Jeffrey Anderson II
- Gloria Jean Andes
- Andrew Cha D.C PC
- Angela M. Caiazza, PC
- Aaron Annis
- Bethy Mae Annsa
- Antara Acupuncture and Herbal Clinic LLC
All providers in Gresham, OR · Behavior Technician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.