Provider Demographics
NPI:1679307953
Name:MCFERRIN, NIA
Entity type:Individual
Prefix:
First Name:NIA
Middle Name:
Last Name:MCFERRIN
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 1:4610 N TRENTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-2081
Mailing Address - Country:US
Mailing Address - Phone:503-797-7222
Mailing Address - Fax:
Practice Address - Street 1:4610 N TRENTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-2081
Practice Address - Country:US
Practice Address - Phone:503-797-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health