| None | |
|
15645 Se 114th Ave Suite #201 Clackamas OR 97015-9047 | |
| (503) 303-5911 | |
| (503) 344-6316 |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 15645 Se 114th Ave, Clackamas, Oregon |
| Authorized Official Name and Position | Denise Lynette Best (CLINIC DIRECTOR) |
| Authorized Official Contact | 5033035911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 15645 Se 114th Ave Suite #201 Clackamas OR 97015-9047 Ph: (503) 303-5911 | None 15645 Se 114th Ave Suite #201 Clackamas OR 97015-9047 Ph: (503) 303-5911 |
| NPI Number | 1548324940 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 02/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548324940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C3247 (Oregon) | Primary |
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