Provider Demographics
NPI:1174226450
Name:FEO, ALEJANDRO R (THW-CHW, CRM, DOULA)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:R
Last Name:FEO
Suffix:
Gender:M
Credentials:THW-CHW, CRM, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 SW 4TH AVE APT 801
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5566
Mailing Address - Country:US
Mailing Address - Phone:470-257-8363
Mailing Address - Fax:
Practice Address - Street 1:1818 SW 4TH AVE APT 801
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5566
Practice Address - Country:US
Practice Address - Phone:470-257-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty