Ms Ilse Vianey Gonzalez Antonio, is a
Peer Specialist based in Portland, Oregon. Ms Ilse Vianey Gonzalez Antonio is licensed to practice in Oregon (license number 1041C0700X) and her current practice location is
1904 Se Division St, Portland, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 517-8663.
NPI number for Ms Ilse Vianey Gonzalez Antonio is 1992502462 and her current mailing address is 1904 Se Division St, Portland, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992502462.
Healthcare Provider's Profile
Full Name | Ms Ilse Vianey Gonzalez Antonio |
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Gender | Female |
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Speciality | Peer Specialist |
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Location | 1904 Se Division St, Portland, Oregon |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1992502462
- Provider Enumeration Date: 03/03/2025
- Last Update Date: 03/03/2025
Medical Identifiers
Medical identifiers for Ms Ilse Vianey Gonzalez Antonio such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992502462 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
104100000X | Social Worker | (* (Not Available)) | Secondary |
175T00000X | Peer Specialist | 1041C0700X (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. Ms Ilse Vianey Gonzalez Antonio 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 Address | Practice Location Address |
Ms Ilse Vianey Gonzalez Antonio, 1904 Se Division St, Portland, OR 97202-1146 Ph: (503) 517-8663 | Ms Ilse Vianey Gonzalez Antonio, 1904 Se Division St, Portland, OR 97202-1146 Ph: (503) 517-8663 |
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