Individual
NICK BENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
2120 EXCHANGE ST, SUITE 301, ASTORIA, OR 97103-3365
(503) 325-0241
Mailing address
1411 EXCHANGE ST, 4, ASTORIA, OR 97103-3847
(503) 440-4037
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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