George Ivar Hannibal, LCSW, CADCI | |
1419 Ne 69th Ave, Portland, OR 97213-5301 | |
(503) 254-1545 | |
(503) 525-2846 |
Full Name | George Ivar Hannibal |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 1419 Ne 69th Ave, Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003866708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | L0525 (Oregon) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 01-11-26 (Oregon) | Primary |
Mailing Address | Practice Location Address |
---|---|
George Ivar Hannibal, LCSW, CADCI 1419 Ne 69th Ave, Portland, OR 97213-5301 Ph: (503) 254-1545 | George Ivar Hannibal, LCSW, CADCI 1419 Ne 69th Ave, Portland, OR 97213-5301 Ph: (503) 254-1545 |
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