| Mayfield Enterprises | |
|
19013 Ne Couch Ln Portland OR 97230-7861 | |
| (971) 255-3220 | |
| Not Available |
| Full Name | Mayfield Enterprises |
|---|---|
| Speciality | Counselor - Professional |
| Location | 19013 Ne Couch Ln, Portland, Oregon |
| Authorized Official Name and Position | Krispin Mayfield (OWNER / THERAPIST) |
| Authorized Official Contact | 9712553220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mayfield Enterprises 19013 Ne Couch Ln Portland OR 97230-7861 Ph: (971) 255-3220 | Mayfield Enterprises 19013 Ne Couch Ln Portland OR 97230-7861 Ph: (971) 255-3220 |
| NPI Number | 1255171922 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255171922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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