Alicia Banister, - in Portland, OR

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Alicia Banister, is a Counselor - Mental Health based in Portland, Oregon. Alicia Banister is licensed to practice in Oregon (license number C6803) and her current practice location is 3930 Se Ivon St, Portland, Oregon. She can be reached at her office (for appointments etc.) via phone at (503) 893-2067.

NPI number for Alicia Banister is 1649668138 and her current mailing address is 3930 Se Ivon St, Portland, Oregon. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649668138.

Contact Information

Alicia Banister,
3930 Se Ivon St,
Portland, OR 97202-1651
(503) 893-2067
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameAlicia Banister
GenderFemale
SpecialityCounselor - Mental Health
Location3930 Se Ivon St, Portland, Oregon
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1649668138
  • Provider Enumeration Date: 01/06/2015
  • Last Update Date: 08/24/2023

Medical Identifiers

Medical identifiers for Alicia Banister such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649668138NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225700000XMassage Therapist 21093 (Oregon)Secondary
101YM0800XCounselor - Mental Health C6803 (Oregon)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alicia Banister is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Alicia Banister,
3930 Se Ivon St,
Portland, OR 97202-1651

Ph: (503) 893-2067		Alicia Banister,
3930 Se Ivon St,
Portland, OR 97202-1651

Ph: (503) 893-2067

Reviews and Comments



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