Provider Demographics
NPI:1285938944
Name:BELGUITH, AMEL
Entity type:Individual
Prefix:MRS
First Name:AMEL
Middle Name:
Last Name:BELGUITH
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 1:3633 SE 35TH PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3365
Mailing Address - Country:US
Mailing Address - Phone:503-494-4222
Mailing Address - Fax:503-494-8080
Practice Address - Street 1:3633 SE 35TH PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3365
Practice Address - Country:US
Practice Address - Phone:503-494-4222
Practice Address - Fax:503-494-8080
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR248460Medicaid