Hannibal, George Ivar

Hannibal, George Ivar is an sole proprietor health care provider with primary practice located at 1419 Ne 69Th Ave , Portland OR 97213-5301. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Hannibal, George Ivar can be contacted via phone (503) 254-1545.

Contact Information

Primary practice address
1419 Ne 69Th Ave Portland OR 97213-5301
Phone: (503) 254-1545
Fax: (503) 525-2846
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X L0525 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 01-11-26 Oregon

Profile Details

NPI number 1003866708
LBN Legal business name Hannibal, George Ivar
Credentials LCSW, CADCI
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Jul 8th, 2007 - about 19 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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