Petrik, Marla Vivian

Petrik, Marla Vivian is an sole proprietor health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Petrik, Marla Vivian can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (541) 523-4927
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Community Health Worker 172V00000X 106768 Oregon

Profile Details

NPI number 1679134209
LBN Legal business name Petrik, Marla Vivian
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 25th, 2019
Last updated Jul 13th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1679134209 NPPES
Oregon MEDICAID 500809171
Oregon Other 2672690

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