| Oregon Behavioral Health Group Llc | |
|
312 Oak St Ste 205 Central Point OR 97502-2542 | |
| (541) 727-7787 | |
| (541) 727-7529 |
| Full Name | Oregon Behavioral Health Group Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 312 Oak St Ste 205, Central Point, Oregon |
| Authorized Official Name and Position | Shannon Ryan (OWNER) |
| Authorized Official Contact | 5417277787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon Behavioral Health Group Llc 312 Oak St Ste 205 Central Point OR 97502-2542 Ph: (541) 727-7787 | Oregon Behavioral Health Group Llc 312 Oak St Ste 205 Central Point OR 97502-2542 Ph: (541) 727-7787 |
| NPI Number | 1528643517 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Medicare PECOS PAC ID | 6103235809 |
|---|---|
| Medicare Enrollment ID | O20210510002571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528643517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Julie J Ryder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184634743 PECOS PAC ID: 0345266391 Enrollment ID: I20120725000926 |
| Provider Name | Tawnya Yockey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245659986 PECOS PAC ID: 4981907268 Enrollment ID: I20160120001080 |
| Provider Name | Jennifer J Marks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972928034 PECOS PAC ID: 3971895863 Enrollment ID: I20160713002489 |
| Provider Name | Pamela J Rossio |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1942395884 PECOS PAC ID: 9931403813 Enrollment ID: I20161006002364 |
| Provider Name | Shannon C Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154602746 PECOS PAC ID: 3870886583 Enrollment ID: I20200629002787 |
| Provider Name | Pamela J Rossio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942395884 PECOS PAC ID: 9931403813 Enrollment ID: I20230627000724 |
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