Provider Demographics
NPI:1720879216
Name:DIAZ, CHELSEA MORGAN
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MORGAN
Last Name:DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7819 SE REEDWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-5158
Mailing Address - Country:US
Mailing Address - Phone:406-361-1066
Mailing Address - Fax:
Practice Address - Street 1:10175 SW BARBUR BLVD STE 212
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5955
Practice Address - Country:US
Practice Address - Phone:971-272-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No172V00000XOther Service ProvidersCommunity Health Worker