| Pacific Mental Health Clinic | |
|
1390 Se 122nd Ave Portland OR 97233-1203 | |
| (206) 489-8775 | |
| Not Available |
| Full Name | Pacific Mental Health Clinic |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1390 Se 122nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Kadra Abdullahi Mohamed (OWNER) |
| Authorized Official Contact | 2064898775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Mental Health Clinic 1390 Se 122nd Ave Portland OR 97233-1203 Ph: (206) 489-8775 | Pacific Mental Health Clinic 1390 Se 122nd Ave Portland OR 97233-1203 Ph: (206) 489-8775 |
| NPI Number | 1699535195 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699535195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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