Anderson, Corey Dean

Anderson, Corey Dean is an individual health care provider with primary practice located at 5120 Se 118Th Ave , Portland OR 97266-3250. He recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Adult Companion, Behavioral Health & Social Service Providers / Mental Health. Nursing Service Related Providers / Adult Companion is his primary health care specialty. Anderson, Corey Dean can be contacted via phone (503) 762-3431.

Contact Information

Primary practice address
5120 Se 118Th Ave Portland OR 97266-3250
Phone: (503) 762-3431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Adult Companion 372600000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1144598822
LBN Legal business name Anderson, Corey Dean
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2011
Last updated Mar 27th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144598822 NPPES
Oregon MEDICAID 171M00000X

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