Pine Mountain Counseling | |
7805 Sw 40th Ave Unit 19932 Portland OR 97219-1643 | |
(503) 455-4305 | |
Not Available |
Full Name | Pine Mountain Counseling |
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Speciality | Counselor - Mental Health |
Location | 7805 Sw 40th Ave Unit 19932, Portland, Oregon |
Authorized Official Name and Position | Cerina Griffin (OWNER) |
Authorized Official Contact | 5034554305 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pine Mountain Counseling Po Box 19932 Portland OR 97280-0932 Ph: (503) 455-4305 | Pine Mountain Counseling 7805 Sw 40th Ave Unit 19932 Portland OR 97219-1643 Ph: (503) 455-4305 |
NPI Number | 1790305233 |
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Provider Enumeration Date | 04/24/2020 |
Last Update Date | 04/24/2020 |
Certification Date | 04/24/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790305233 | NPI | - | NPPES |
1700281730 | Other | CA | NPI AS SOLE PROPRIETOR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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