| Cherry Hills Neuropsychology Llc | |
|
698 12th Street Se Suite 240 Office 6 Salem OR 97301 | |
| (971) 301-4771 | |
| Not Available |
| Full Name | Cherry Hills Neuropsychology Llc |
|---|---|
| Speciality | Psychologist |
| Location | 698 12th Street Se, Salem, Oregon |
| Authorized Official Name and Position | Ashley Watts (MEMBER, NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 5056205560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherry Hills Neuropsychology Llc Po Box 13883 Salem OR 97309-1883 Ph: (971) 301-4771 | Cherry Hills Neuropsychology Llc 698 12th Street Se Suite 240 Office 6 Salem OR 97301 Ph: (971) 301-4771 |
| NPI Number | 1194402156 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Medicare PECOS PAC ID | 2365896883 |
|---|---|
| Medicare Enrollment ID | O20231002001664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194402156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ashley Kristen Watts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568998763 PECOS PAC ID: 5597038349 Enrollment ID: I20170830002050 |
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