| Jean A Daniels | |
|
9155 Sw Barnes Rd Suite 418 Portland OR 97225-6625 | |
| (503) 284-8841 | |
| Not Available |
| Full Name | Jean A Daniels |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9155 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Jean A Daniels (OWNER) |
| Authorized Official Contact | 9712700995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jean A Daniels 3439 Ne Sandy Blvd Pmb 375 Portland OR 97232 Ph: (503) 284-8841 | Jean A Daniels 9155 Sw Barnes Rd Suite 418 Portland OR 97225-6625 Ph: (503) 284-8841 |
| NPI Number | 1851725709 |
|---|---|
| Provider Enumeration Date | 08/28/2013 |
| Last Update Date | 08/28/2013 |
| Medicare PECOS PAC ID | 9032349139 |
|---|---|
| Medicare Enrollment ID | O20140312000916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851725709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 201391588NP-PP (Oregon) | Primary |
| Provider Name | Jean A Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558490441 PECOS PAC ID: 5496994097 Enrollment ID: I20140415002192 |
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