Banister, Alicia

Banister, Alicia is an individual health care provider with primary practice located at 3930 Se Ivon St , Portland OR 97202-1651. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Banister, Alicia can be contacted via phone (503) 893-2067.

Contact Information

Primary practice address
3930 Se Ivon St Portland OR 97202-1651
Phone: (503) 893-2067
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 21093 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C6803 Oregon

Profile Details

NPI number 1649668138
LBN Legal business name Banister, Alicia
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2015
Last updated Aug 24th, 2023 - about 3 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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