| Heartful Path Therapy | |
|
7334 N Chicago Ave Portland OR 97203-4869 | |
| (503) 928-7491 | |
| Not Available |
| Full Name | Heartful Path Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 7334 N Chicago Ave, Portland, Oregon |
| Authorized Official Name and Position | J Workman-purvine (OWNER) |
| Authorized Official Contact | 5039287491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartful Path Therapy 7334 N Chicago Ave Portland OR 97203-4869 Ph: (503) 928-7491 | Heartful Path Therapy 7334 N Chicago Ave Portland OR 97203-4869 Ph: (503) 928-7491 |
| NPI Number | 1962842526 |
|---|---|
| Provider Enumeration Date | 06/27/2013 |
| Last Update Date | 06/05/2020 |
| Certification Date | 06/05/2020 |
| Medicare PECOS PAC ID | 0749423168 |
|---|---|
| Medicare Enrollment ID | O20130903000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962842526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5170 (Oregon) | Primary |
| Provider Name | J Roscoe Workman Purvine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851689368 PECOS PAC ID: 5698911006 Enrollment ID: I20130409000291 |
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