| Portland Psychotherapy Clinic | |
|
3700 N Williams Ave Portland OR 97227-1441 | |
| (503) 281-4852 | |
| Not Available |
| Full Name | Portland Psychotherapy Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3700 N Williams Ave, Portland, Oregon |
| Authorized Official Name and Position | Jason Luoma (LICENSED PSYCHOLOGIST, PRESIDENT) |
| Authorized Official Contact | 5032814852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Psychotherapy Clinic 3700 N Williams Ave Portland OR 97227-1441 Ph: (503) 281-4852 | Portland Psychotherapy Clinic 3700 N Williams Ave Portland OR 97227-1441 Ph: (503) 281-4852 |
| NPI Number | 1063626315 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 05/03/2017 |
| Medicare PECOS PAC ID | 8729264916 |
|---|---|
| Medicare Enrollment ID | O20110524000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063626315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1661 (Oregon) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brian Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821310061 PECOS PAC ID: 6608052782 Enrollment ID: I20110526000026 |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Cascadia Behavioral Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2926 Ne Flanders St Ste 3c, Portland, OR 97232 Phone: 971-270-0167 |