Portland Pediatric Psychology, Llc in Portland - Community/behavioral Health
Portland Pediatric Psychology, Llc - NPI 1508992652
Portland Pediatric Psychology, Llc is a Community/behavioral Health in Portland, Oregon. Portland Pediatric Psychology, Llc practices all healthcare services and medical treatments related to Community/behavioral Health. The NPI Number for Portland Pediatric Psychology, Llc is 1508992652. The last update date is 2015-03-25.
Portland Pediatric Psychology, Llc's current location address is 1012 Sw King Ave., Portland, Oregon. You can contact this provider via phone number 5036736246. The mailing address for Portland Pediatric Psychology, Llc is 1012 Sw King Ave., Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Portland Pediatric Psychology, Llc |
---|---|
Address | 1012 Sw King Ave., Portland, Oregon |
Phone Number | 5036736246 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | OWNER/THER |
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Authorized Official Name | Gray Grubbs Glori |
Credentials | PSYD, MSW |
Telephone Number | 5036736246 |
NPI Number Detail
NPI Number | 1508992652 |
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Provider Enumeration Date | 2007-02-25 |
Last Updated Date | 2015-03-25 |
Provider Mailing Address Detail
Address | 1012 Sw King Ave. |
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City | Portland |
State | Oregon (OR) |
Post Code | 972053035 |
Phone Number | 5036736246 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Community/behavioral Health |
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Taxonomy | 251S00000X |
Licence No | 2482 |
Definition: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those dis |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
3598 | NC | CAROLINAS BEHAVIORAL HEAL | |
135J9 | NC | BLUE CROSS BLUE SHIELD | |
6002627 | NC | -- |
Post Comment/ Review Below
What is the Portland Pediatric Psychology, Llc's unique identification number?
The Portland Pediatric Psychology, Llc has been assigned the NPI (National Provider Identifier) Number 1508992652 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Portland Pediatric Psychology, Llc is physically located?
The Portland Pediatric Psychology, Llc is physically situated at the following address: 1012 Sw King Ave., Portland, OR, 972053035.
What is Portland Pediatric Psychology, Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Portland Pediatric Psychology, Llc is Community/behavioral Health, and the corresponding taxonomy classification code for this specialized field is 251S00000X.
On what date did the Portland Pediatric Psychology, Llc receive its 1508992652 assignment from the Centers for Medicare & Medicaid Services?
The Portland Pediatric Psychology, Llc was assigned its 1508992652 by the Centers for Medicare & Medicaid Services on 2007-02-25.
As of what date were the details pertaining to Portland Pediatric Psychology, Llc last refreshed?
The information related to the Portland Pediatric Psychology, Llc, including its address, specialty, and other relevant details, was last updated on 2015-03-25.
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