Provider Demographics
NPI:1457972978
Name:VARELA, NAOMI KATHLEEN
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:KATHLEEN
Last Name:VARELA
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 1:1855 NW 173RD AVE APT 2013
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7380
Mailing Address - Country:US
Mailing Address - Phone:323-503-9235
Mailing Address - Fax:
Practice Address - Street 1:1855 NW 173RD AVE APT 2013
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7380
Practice Address - Country:US
Practice Address - Phone:323-503-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147003106H00000X
ORT3126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist