George Ivar Hannibal in Portland - Addiction (substance Use Disorder)
George Ivar Hannibal - NPI 1003866708
George Ivar Hannibal is a Addiction (substance Use Disorder) in Portland, Oregon. George Ivar Hannibal practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for George Ivar Hannibal is 1003866708. The last update date is 2007-07-08.
George Ivar Hannibal's current location address is 1419 Ne 69th Ave, Portland, Oregon. You can contact this provider via phone number 5032541545 and fax number 5035252846. The mailing address for George Ivar Hannibal is 1419 Ne 69th Ave, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | George Ivar Hannibal |
|---|---|
| Address | 1419 Ne 69th Ave, Portland, Oregon |
| Phone Number | 5032541545 |
| Fax Number | 5035252846 |
| Sole Proprietor | Y |
| Credentials | LCSW, CADC |
NPI Number Detail
| NPI Number | 1003866708 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1419 Ne 69th Ave |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972135301 |
| Phone Number | 5032541545 |
| Fax Number | 5035252846 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 2026-01-11 0 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Post Comment/ Review Below
Could you share the physical location details of George Ivar Hannibal?
The George Ivar Hannibal is situated at 1419 Ne 69Th Ave, in the city of Portland, state of OR, with the zip code 972135301.
What is George Ivar Hannibal's area of expertise and its corresponding taxonomy classification?
The George Ivar Hannibal's field of specialization is Addiction (substance Use Disorder), and it falls under the taxonomy code 101Ya0400X, which categorizes healthcare providers based on their areas of practice.
When did George Ivar Hannibal receive its 1003866708 assignment?
The George Ivar Hannibal was assigned its 1003866708 on 2006-05-11, which is the date when this unique identifier was issued to the organization.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1003866708 to George Ivar Hannibal?
The Centers for Medicare & Medicaid Services originally issued the 1003866708 to George Ivar Hannibal on 2006-05-11.
When was the information regarding George Ivar Hannibal, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to George Ivar Hannibal, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.