Provider Demographics
NPI:1356100101
Name:NEWELL, ERIN JANAE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:JANAE
Last Name:NEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RINNY
Other - Middle Name:JANAE
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1636 NE TILLAMOOK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-4466
Mailing Address - Country:US
Mailing Address - Phone:916-956-6708
Mailing Address - Fax:
Practice Address - Street 1:1942 NW KEARNEY ST STE 11
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1463
Practice Address - Country:US
Practice Address - Phone:971-254-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health