Organization
GEORGE I. HANNIBAL
Active
Organization
GEORGE I. HANNIBAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE IVAR. HANNIBAL LCSW (OWNER/OPERATOR)
(503) 254-1545
Entity
Organization
Contact information
Practice address
1419 NE 69TH AVE, PORTLAND, OR 97213-5301
(503) 254-1545
(503) 525-2846
Mailing address
1419 NE 69TH AVE, PORTLAND, OR 97213-5301
(503) 254-1545
(503) 525-2846
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
L525
OR
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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