| Integrative Nw | |
|
10260 Sw Greenburg Road Suite 400 Portland OR 97223-5500 | |
| (503) 575-1317 | |
| (503) 388-4144 |
| Full Name | Integrative Nw |
|---|---|
| Speciality | Psychologist |
| Location | 10260 Sw Greenburg Road, Portland, Oregon |
| Authorized Official Name and Position | Babak Govan (OWNER/PROVIDER) |
| Authorized Official Contact | 8185222106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Nw 18946 Tuba Street Northridge CA 91324-1230 Ph: (818) 522-2106 | Integrative Nw 10260 Sw Greenburg Road Suite 400 Portland OR 97223-5500 Ph: (503) 575-1317 |
| NPI Number | 1568870608 |
|---|---|
| Provider Enumeration Date | 07/31/2014 |
| Last Update Date | 06/27/2022 |
| Certification Date | 06/27/2022 |
| Medicare PECOS PAC ID | 2062735426 |
|---|---|
| Medicare Enrollment ID | O20141216002590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568870608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Avid G Farahani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558515338 PECOS PAC ID: 3870770001 Enrollment ID: I20110615000490 |
| Provider Name | Babak Govan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124260948 PECOS PAC ID: 6901055508 Enrollment ID: I20120925000360 |
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Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
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