| Legacy Good Samaritan Hospital And Medical Center | |
|
1015 Nw 22nd Ave Portland OR 97210-3025 | |
| (503) 413-4848 | |
| Not Available |
| Full Name | Legacy Good Samaritan Hospital And Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1015 Nw 22nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Sarah Jensen (INTERIM CFO) |
| Authorized Official Contact | 5034155145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Good Samaritan Hospital And Medical Center Po Box 4037 Portland OR 97208-4037 Ph: (503) 413-4048 | Legacy Good Samaritan Hospital And Medical Center 1015 Nw 22nd Ave Portland OR 97210-3025 Ph: (503) 413-4848 |
| NPI Number | 1336162874 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 01/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336162874 | NPI | - | NPPES |
| 077404 | Medicaid | OR | |
| 2010683 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 14-0027 (Oregon) | Primary |
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 | |
Cascadia Behavioral Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
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 |