|
| |
|
9155 Sw Barnes Rd Suite 418 Portland OR 97225-6625 | |
| (503) 284-8841 | |
| Not Available |
| Full Name | |
|---|---|
| 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 |
|---|---|
3439 Ne Sandy Blvd Pmb 375 Portland OR 97232 Ph: (503) 284-8841 | 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 |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
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 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2926 Ne Flanders St Ste 3c, Portland, OR 97232 Phone: 971-270-0167 |