| Paul Myers, Ph.d., Llc | |
|
5441 Sw Macadam Ave Ste 104 Portland OR 97239-3821 | |
| (503) 381-6685 | |
| (503) 248-6385 |
| Full Name | Paul Myers, Ph.d., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5441 Sw Macadam Ave Ste 104, Portland, Oregon |
| Authorized Official Name and Position | Paul Ryan Myers (OWNER/PROVIDER) |
| Authorized Official Contact | 5033816685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Myers, Ph.d., Llc 5441 Sw Macadam Ave Ste 104 Portland OR 97239-3821 Ph: (503) 381-6685 | Paul Myers, Ph.d., Llc 5441 Sw Macadam Ave Ste 104 Portland OR 97239-3821 Ph: (503) 381-6685 |
| NPI Number | 1134633100 |
|---|---|
| Provider Enumeration Date | 11/28/2017 |
| Last Update Date | 11/28/2017 |
| Medicare PECOS PAC ID | 5092075747 |
|---|---|
| Medicare Enrollment ID | O20180129001420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134633100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1092 (Oregon) | Primary |
| Provider Name | Paul R Myers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235333766 PECOS PAC ID: 8628338373 Enrollment ID: I20180129001479 |
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