NPI 1053595785 · live from the CMS NPI Registry
Miya Gray Abbott, Licensed Clinical So
Social Worker, Clinical in Portland, OR. National Provider Identifier 1053595785, active.
NPI record
| NPI | 1053595785 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 2304 E. Bumside St., Suite 201, Portland, OR 97214 |
| Practice phone | 503-951-0328 |
| Mailing address | 2304 E Burnside St Ste 201, Portland, OR 97214 |
| Enumerated | December 17, 2007 |
| Last updated | October 23, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | — |
| Social Worker, Clinical primary | 1041C0700X | L4914 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.